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2010, Número 4

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Rev Mex Anest 2010; 33 (4)


Azul de metileno para el manejo del choque séptico refractario a vasopresores

Carrillo-Esper R, Sosa-García JO, Carrillo-Córdova JR, Carrillo-Córdova LD

Idioma: Español
Referencias bibliográficas: 34
Paginas: 214-219
Archivo PDF: 360.42 Kb.


RESUMEN

Introducción: El óxido nítrico (ON) endógeno induce vasodilatación en enfermos con choque séptico por medio de la activación de la guanilato ciclasa. El objetivo de este trabajo es describir los efectos de la infusión de azul de metileno, un inhibidor de la síntesis de óxido nítrico, en el comportamiento hemodinámico y requerimiento de vasopresores en un enfermo con choque séptico refractario y revisar los consensos actuales relacionados a esta interesante alternativa terapéutica. Caso clínico: Enfermo de 64 años con choque séptico refractario al manejo con líquidos, vasopresores, inotrópicos y esteroides. Se administró azul de metileno a dosis de 2 mg/kg. Posterior a su infusión se presentó mejoría del gasto cardíaco, presión arterial media y saturación venosa de oxígeno. Fue posible disminuir la dosis de vasopresores e inotrópicos. Conclusión: El azul de metileno tiene efecto vasopresor en enfermos con choque séptico refractario. Recomendamos su uso temprano y oportuno


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