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2005, Número 2

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Cir Cir 2005; 73 (2)


Alteraciones fisiopatológicas secundarias a circulación extracorpórea en cirugía cardíaca

Valenzuela-Flores AG, Valenzuela-Flores AA, Ortega-Ramírez JA, Penagos-Paniagua M, Pérez-Campos JP

Idioma: Español
Referencias bibliográficas: 56
Paginas: 143-149
Archivo PDF: 73.31 Kb.


RESUMEN

La circulación extracorpórea (derivación cardiopulmonar) es uno de los métodos utilizados en la cirugía convencional de revascularización coronaria. Su uso puede asociarse con el desarrollo de eventos adversos que, si bien no comunes (‹2%), pueden aumentar la mortalidad en 70 %. La cirugía cardíaca y la circulación extracorpórea activan la respuesta inflamatoria caracterizada por alteraciones cardiovasculares y pulmonares. La respuesta inflamatoria se inicia durante la cirugía cardíaca por diversos procesos, entre ellos el contacto de la sangre con el aparato de derivación cardiopulmonar, desarrollo de isquemia y daño por repercusión, así como liberación de endotoxinas. En el curso de la circulación extracorpórea los tres procesos están presentes y contribuyen a la respuesta inflamatoria sistémica. El término “respuesta inflamatoria sistémica” ha sido propuesto para describir los cambios que se sobreponen a la respuesta fisiológica normal después de una cirugía. Una complicación frecuente de esta respuesta es el síndrome de falla orgánica múltiple, que incluye la insuficiencia respiratoria aguda, choque e insuficiencia renal. El propósito de esta revisión es examinar y entender los mecanismos patológicos responsables de la respuesta inflamatoria ocurrida con la utilización de circulación extracorpórea en la cirugía cardíaca.


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