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2012, Número S1

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Rev Mex Anest 2012; 35 (S1)


Monitorización de las variables hemometabólicas en el paciente neuroquirúrgico

Jaramillo-Magaña JJ

Idioma: Español
Referencias bibliográficas: 21
Paginas: 33-36
Archivo PDF: 85.25 Kb.


FRAGMENTO

Tradicionalmente, el primer parámetro que se ha utilizado en la clínica para evaluar el deterioro cerebral es la presión intracraneal (PIC). La elevación de la PIC secundaria a un incremento en el volumen intracraneal induce a un nuevo y progresivo daño cerebral secundario, el cual a su vez puede inducir y mantener un círculo vicioso. Existe la creencia sobresimplificada de que un incremento en la PIC por arriba de 20 mmHg es patológico y de que la PIC normal (‹ 15 mmHg) garantiza la ausencia de un proceso patológico. Las nuevas técnicas de neuromonitoreo han demostrado que esto es incorrecto. Los nuevos datos provenientes del neuromonitoreo muestran que las alteraciones metabólicas y funcionales preceden cualquier incremento en la PIC después de trauma craneal. Es importante recalcar que este umbral de 20 mmHg se estableció antes de que el neuromonitoreo extendido (SvjO2, PtiO2, microdiálisis, Doppler transcraneal: DTC) se integrara a la rutina en la neuromonitorización.


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