2019, Número 2
Almidón como factor de riesgo para el incremento del sangrado transquirúrgico en la artroplastia total de cadera
Cruz-Guerrero RF, Jiménez-Ávila JM, González-Cisneros AC, Rivera-Villa AH, Sánchez-Chávez FA, Rincón-Gómez MR, Morales-De los Santos R, Rivera-Villa ÁO, Pérez-Atanasio JM
Idioma: Español
Referencias bibliográficas: 33
Paginas: 164-169
Archivo PDF: 235.65 Kb.
RESUMEN
Objetivo: Determinar si el uso de almidón en la artroplastia de cadera es un factor de riesgo para el sangrado transquirúrgico
excesivo y el uso de concentrados eritrocitarios.
Método: Estudio retrospectivo observacional analítico de 240 pacientes
sometidos a artroplastia total de cadera primaria desde enero de 2015 hasta enero de 2016. Se integraron dos grupos: almidón
(94 pacientes) y no almidón (146 pacientes). Se analizaron la edad, el sexo, el índice de masa corporal, la hemoglobina
prequirúrgica y posquirúrgica, el uso de concentrados eritrocitarios y el sangrado transquirúrgico.
Resultados: El grupo con
almidón tuvo mayor riesgo de sangrado transquirúrgico excesivo (odds ratio [OR]: 3.58; intervalo de confianza del 95%
[IC 95%]: 2.05- 6.26) y de transfusión de concentrados eritrocitarios (OR: 3.12; IC 95%: 1.76-5.5). En el grupo con almidón
hubo una media de sangrado transquirúrgico de 396 ml (desviación estándar [DE]: ± 234.94) y una disminución de la hemoglobina
de 4.6 g/dl (DE: ± 1.38); en el grupo de no almidón hubo una media de sangrado de 271.8 ml (DE: ± 139.22) y una
disminución de la hemoglobina de 3.34 g/dl (DE: ± 1.4).
Discusión: Los pacientes con almidón presentaron mayor sangrado
transquirúrgico y requirieron en más ocasiones la transfusión de hemoderivados que los del grupo control, por lo que sugerimos
considerar las posibles complicaciones relacionadas con el uso de hidroxietilalmidón.
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