Santillana JA, Muñoz RMR, Sánchez NVM, Chávez PCE, Barrientos QLA, Flores MP

Idioma: Español
Referencias bibliográficas: 46
Paginas: 225-231
Archivo PDF: 181.07 Kb.

RESUMEN

El delirium es una entidad clínica caracterizada por una disfunción aguda en el estado de consciencia con alteraciones de la cognición, atención y curso fluctuante. Se trata de una enfermedad con alta prevalencia en pacientes críticamente enfermos con implicaciones pronósticas. La inflamación sistémica tiene un papel importante en la aparición del delirium y la disfunción cerebral aguda. El objetivo del estudio es buscar una relación entre marcadores clínicos de inflamación, principalmente la depuración de procalcitonina a las 72 horas y su asociación con el desarrollo de delirium en los pacientes de terapia intensiva con síndrome de respuesta inflamatoria sistémica (SIRS). Esto se refleja en los días libres de delirium o coma que el paciente cursa en la unidad de cuidados intensivos (UCI). Se trató de un estudio retrospectivo, en el cual se analizaron 126 pacientes, se observó una mortalidad hospitalaria de 23.01% y se detectó delirium por CAM-ICU en 69 (55.2%) de los pacientes. En los pacientes que presentaron delirium se encontraron mayores niveles séricos de procalcitonina al ingreso, a las 24, 48 y 72 horas frente a quienes no lo presentaron. No hubo diferencia entre los niveles de proteína C reactiva ni diferencias significativas en el porcentaje de depuración de procalcitonina entre los pacientes que presentaron delirium y aquéllos que no. Se detectó un cociente de riesgo de 0.97 (IC 0.96-0.99; p = 0.0154) por unidad de proteína C reactiva y un cociente de riesgo de 1.17 (IC 1.02-1.35; p = 0.0261) por unidad de aclaramiento de procalcitonina a las 48 horas. Se concluyó que, en pacientes con respuesta inflamatoria sistémica y delirium, algunos marcadores de inflamación están significativamente elevados y representan un factor de riesgo de tener menos días neurológicos normales.

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