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2004, Número 3

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Rev Mex Anest 2004; 27 (3)


Vasopresina.Su aplicación en anestesiología

Carrillo-Esper R, Carvajal-Ramos R

Idioma: Español
Referencias bibliográficas: 84
Paginas: 157-166
Archivo PDF: 95.80 Kb.


RESUMEN

La deficiencia de vasopresina es característica del estado de choque vasodilatado refractario. La vasopresina actúa a través de 3 diferentes receptores de proteína G denominados V1a, V1b y V2. En diversos estudios experimentales y ensayos clínicos se ha demostrado su utilidad en choque séptico, postcirugía cardíaca, hipovolémico en fase dilatada, hipotensión trans-operatoria inducida por inhibidores de la ECA y milrinona, paro cardíaco y taquicardia ventricular sin pulsos y fibrilación ventricular. En estados de choque con vasodilatación la dosis recomendada es de 0.01 a 0.04 UI/min, dosis más elevadas se asocian a isquemia miocárdica, esplácnica y cutánea. La terlipresina a dosis de 1 mg en dosis única es el tratamiento de elección en la hipotensión refractaria transoperatoria secundaria a inhibidores de la ECA y milrinona. En taquicardia ventricular sin pulsos y fibrilación ventricular de acuerdo a la Asociación Americana de Cardiología es recomendación IIb.


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