Carrillo ER, Carrillo CJR, Carrillo CLD, Carrillo CCA

Idioma: Español
Referencias bibliográficas: 68
Paginas: 132-137
Archivo PDF: 161.89 Kb.

RESUMEN

Para lograr una adecuada sedoanalgesia en el enfermo grave se requiere de la adecuada selección de los medicamentos, sus dosis y combinaciones para lograr objetivos específicos. Se requiere también optimizar la dosis y mantener niveles óptimos para minimizar los riesgos de la sobresedación, infrasedación y los efectos colaterales de los medicamentos. Los síndromes de supresión secundarios a la suspensión de benzodiacepinas, opioides y propofol son frecuentes en la Unidad de Terapia Intensiva y pueden complicar y retardar la recuperación de los enfermos, ya que se incrementan sus demandas hemodinámicas, metabólicas y respiratorias. Hipertensión, taquicardia, fiebre y delirium son las principales manifestaciones. Los agonistas alfa 2, de los cuales es relevante la dexmedetomidina son una buena opción para el manejo del síndrome de abstinencia secundaria a la suspensión de la sedoanalgesia al disminuir la hiperactividad adrenérgica. El apego a las recomendaciones basadas en la evidencia relacionadas al retiro juicioso y progresivo de estos medicamentos disminuyen de manera significativa el riesgo del desarrollo de estos síndromes.

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