Duarte-Mote J, Domínguez HI, Vega HC, Lee Eng CV, Romero FS, Espinosa LR, Sánchez RG

Idioma: Español
Referencias bibliográficas: 45
Paginas: 504-512
Archivo PDF: 231.32 Kb.

RESUMEN

La sepsis sigue siendo la principal causa de muerte en las unidades de cuidados intensivos. El nuevo abordaje terapéutico basado en metas ha logrado disminuir el índice de mortalidad; sin embargo, continúa siendo alto. Durante la evolución del proceso séptico, las respuestas inflamatoria sistémica y metabólica al traumatismo conforman las dos principales respuestas de tipo compensatorio con los que el organismo hace frente a la sepsis. Las diferentes fases de la respuesta metabólica al traumatismo denotan diferentes etapas de adaptación orgánica, que muchas veces evolucionan primero a una fase de disfunción orgánica múltiple y luego a una franca insuficiencia orgánica múltiple. El gasto energético basal de los pacientes con sepsis disminuye de manera importante en la etapa de disfunción orgánica múltiple. Las alteraciones funcionales son secundarias a disoxia y menor producción energética en la mitocondria. Esta fase de disfunción puede ser adaptativa del organismo para preservar la citoestructura orgánica. En este artículo se revisan las alteraciones mitocondriales durante la fase de disfunción orgánica múltiple, su relación con el abordaje terapéutico y la importancia en la mortalidad.

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