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2011, Número 4

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Rev Cub Med Int Emerg 2011; 10 (4)


Tromboelastografía vs perfil de coagulación para riesgo de trombosis en el paciente con sepsis severa

Pérez RFJM, Macías GMT, Gómez GRO

Idioma: Español
Referencias bibliográficas: 27
Paginas: 2273-2284
Archivo PDF: 219.58 Kb.


RESUMEN

Introducción: La sepsis severa predispone a la coagulación intravascular diseminada con riesgo de ocasionar microtrombosis y falla orgánica múltiple.
Objetivos: Determinar sensibilidad y especificidad de la tromboelastografía vs el perfil de coagulación para trombosis en pacientes con sepsis severa.
Métodos: Estudio observacional, analítico, comparativo, y prospectivo de mayo a septiembre del 2011 de pacientes con sepsis severa incluyendo en el estudio a › 18 años de ambos sexos, excluyendo a pacientes con hemorragia activa. Se solicitó al ingreso y a las 72 horas el perfil de coagulación y una tromboelastografía. Para variables numéricas se utilizó la prueba U de Mann-Whitney. Para variables cualitativas la prueba de X2.
Resultados: Se analizaron 15 pacientes con una edad promedio de 46 años. Se reportó un incremento del fibrinógeno, del dímero D y de la proteína C, un descenso de la proteína S y de la antitrombina III. La tromboelastografía reportó un alargamiento de tiempo de reacción y del ángulo α, con un acortamiento de tiempo de coagulación y del índice de coagulación.
Conclusiones: El perfil de coagulación y la tromboelastografía tienen buena sensibilidad y baja especificidad para diagnosticar coagulación intravascular diseminada y evaluar el riesgo de trombosis en el paciente con sepsis severa.


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