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2017, Número S1

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Rev Mex Anest 2017; 40 (S1)


Monitorización de oxigenación tisular

Motta-Amézquita LG, Barrera-Fuentes M, Peña-Pérez CA, Tamaríz-Cruz O, Ramírez-Segura EH, Cabrera-Galindo F

Idioma: Español
Referencias bibliográficas: 105
Paginas: 350-364
Archivo PDF: 303.25 Kb.


FRAGMENTO

Es bien sabido que una intervención quirúrgica echa a andar de manera inmediata la respuesta metabólica al trauma, caracterizada por la liberación de hormonas, aumento de liberación de cortisol, resistencia a la insulina, aumento de catecolaminas, inmunodepresión, proteólisis, etc. y un consecuente aumento del consumo de oxígeno tisular, lo que aumenta importantemente el riesgo quirúrgico y la morbimortalidad perioperatoria. También está demostrado que una rápida recuperación del déficit de oxígeno mediante una oportuna GDT (antes de que se establezca una falla orgánica), reduce la morbimortalidad, de modo que la optimización hemodinámica debe iniciarse en el transoperatorio para prevenir la hipo perfusión tisular y debería continuarse por al menos entre 6 y 8 horas en el postoperatorio. No obstante, es bien sabido que no todos los pacientes son capaces de sobreponerse a una «deuda» de oxígeno, esto puede ser debido al tipo de cirugía y al daño tisular secundario aunado a las reservas fisiológicas de cada paciente.


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