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2018, Número S1

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Gac Med Mex 2018; 154 (S1)


Dose in continuous renal replacement therapy

Claure-Del Granado R

Idioma: Ingles.
Referencias bibliográficas: 52
Paginas: 40-47
Archivo PDF: 229.81 Kb.


RESUMEN

Las terapias de reemplazo renal continuo (TRRC) son de los tipos mas empleados de terapias de reemplazo renal para el tratamiento de pacientes con lesión renal aguda (IRA) críticamente enfermos. Guías de practica clínica recientemente publicadas basadas en estudios clínicos recomiendas prescribir una dosis de efluente de 20-25 ml/kg/h, ya que estos ensayos clínicos no pudieron encontrar diferencias en desenlaces como mortalidad o recuperación de la función renal. Sin embargo, el resultado de estos ensayos clínicos recientes no significan que la dosis en TRRC no sea importante, por el contrario estos estudios nos muestran que la dosis tienen que ser continuamente evaluada y modificada de acuerdo a las necesidades clínicas, metabólicas, y fisiológicas de cada paciente. La prescripción de dosis en TRRC necesita ser un proceso dinámico y preciso, en el cual medidas de calidad basadas en evidencia serian empleadas para guiar la prescripción de dosis que cubra las necesidades diarias del paciente. La dosis proporcionada debe de ser constantemente monitorizada para asegurar de que esta sea lograda. Se han propuesto medidas de calidad para la monitorización de la dosis entregada de TRRC, pero aun necesitan ser validadas antes de ser implementadas en la practica clínica diaria.


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