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2014, Número 1

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Cir Plast 2014; 24 (1)


Muerte súbita en pacientes de lipoaspiración: recomendaciones preventivas. Estudio analítico

Cuenca-Pardo JA, Contreras-Bulnes L, Iribarren-Moreno R, Hernández-Valverde C

Idioma: Español
Referencias bibliográficas: 70
Paginas: 16-30
Archivo PDF: 254.76 Kb.


RESUMEN

La Asociación Mexicana de Cirugía Plástica realizó una encuesta para determinar los factores relacionados con la muerte súbita en lipoaspiración. En el periodo de 2005-2014 se reportaron 64 casos; con un incremento de 1,479 casos por cada año (R = 0.983; p ‹ 0.001), se pronostican 18 muertes para el año 2015. El mayor porcentaje de mortalidad relacionado con los años de experiencia de los anestesiólogos fue entre 15 a 20. Hubo 12 fallecimientos antes de iniciar el procedimiento quirúrgico. El mayor porcentaje de mortalidad en cuanto a los años de experiencia de los cirujanos fue de los 20 a los 25. Los procedimientos fueron realizados 15.62% en consultorio, 54.68% en clínicas y 29.68% en hospitales. Las manifestaciones clínicas fueron en el 68.73% hipotensión arterial, disnea con tos, bradicardia y desaturación de oxígeno. Las principales causas de muerte fueron embolismo graso 26.56%, tromboembolia pulmonar 20.31% y desconocida 31.25%. La lidocaína fue utilizada en la solución tumescente en 59.37% de los casos a dosis de 13.88 a 80.64 mg/kg peso. Hubo una fuerte correlación entre la aplicación de lidocaína y el tiempo de muerte transoperatoria; la mayor mortalidad fue en los primeros 60 minutos (B = -2.63% R = 0.924; p = 0.008) y en el postoperatorio la mayor mortalidad se presentó a las 4 horas y se abatió a las 16 horas (B = -4.4% R = -0.917; p = 0.005). Hubo un total de 38 casos (59.37%) de fallecimientos que pudieron haberse prevenido. Se establecen recomendaciones preventivas. Se concluye que los estudios actuales no son determinantes para encontrar causalidad.


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