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2017, Número 3

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Med Crit 2017; 31 (3)


Soluciones balanceadas: cloro el «nuevo villano»

Sánchez DJS, Monares ZE, Meneses OC, Rodríguez MEA, García MRC, Peniche MKG, Huanca PJM, Calyeca SMV

Idioma: Español
Referencias bibliográficas: 36
Paginas: 152-158
Archivo PDF: 166.09 Kb.


RESUMEN

Las consecuencias de la reanimación con líquidos por lo regular se han minimizado y aceptado como un «mal necesario». En la mayoría de los casos su origen es iatrogénico. En años recientes se ha prestado mucha atención a las soluciones balanceadas, las cuales poseen una cantidad de electrolitos más parecida al plasma humano que otro tipo de soluciones. El objetivo de esta revisión es conocer aspectos fisiopatológicos y la evidencia actual respecto al uso de soluciones balanceadas en los pacientes críticamente enfermos, resaltar los efectos deletéreos de la hipercloremia y su asociación a malos resultados. Para comprender cómo funcionan las soluciones balanceadas debe conocerse el modelo de Stewart para las alteraciones ácido-base. El interés por la hipercloremia se debe a que la administración de soluciones es la maniobra más común en medicina crítica y a su vez la solución salina al 0.9% es el líquido que principalmente se administra. La solución salina al 0.9% puede convertirse en un «problema» y no en una «solución» si no se selecciona al paciente correcto. Las soluciones balanceadas son una opción, pero no la misma solución para los diferentes casos de pacientes críticamente enfermos.


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