Flores‑Chagolla GM, Huesca‑Jiménez K, Huesca‑Jiménez G

Idioma: Español
Referencias bibliográficas: 32
Paginas: 307-311
Archivo PDF: 282.35 Kb.

RESUMEN

La hipotermia terapéutica conocida actualmente como manejo de temperatura objetivo, es inducida de manera intencional y controlada hasta una disminución de la temperatura central de 32-36 ^oC. Su uso en pacientes que estuvieron bajo un período de limitación del flujo sanguíneo cerebral ha mostrado beneficios en el pronóstico neurológico. Sin embargo, no está exento de efectos adversos. El dilema surge cuando se nos presenta una paciente gestante en el cual debemos elegir aquellas terapias que logren un equilibrio entre el mejor control de la patología materna con el menor riesgo para el feto. El presente estudio tiene como objetivo realizar una revisión de los efectos fetales de gestantes inducidas a hipotermia y mencionar los reportes de casos que hasta ahora existen.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Clifton W. Calkrway, chair; Michael W. Donnbro; Erika L. Fink, et al. Part 8: post-cardiac arrest care: 2015 American Heart Association guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132:S465-482.

2. Nielsen N, Wetterslev J, al-Subaie N, et al. Target temperature management after out-of-hospital cardiac arrest: a randomized, parallel-group, assessor-blinded clinical trial: rationale and design. Am Heart J. 2012;163:541-548.

3. Carney N, Totten AM, O’Reilly C, et. al. Guidelines for the management of severe traumatic brain injury. Fourth Edition. Neurosurgery. 2017;80:6-15.

4. Andrew PJD, Sinclair L, Rodriguez A, Harris BA, Battison CG, Rhodes JK, et al. Hypothermia for the Eurotherm3235 trial collaborators; hypothermia for intracranial hypertension after traumatic brain injury. N Engl J Med. 2015;373:2403-2412.

5. Dalton DW, Bramlett HM. Therapeutic hypothermia and targeted temperature management in traumatic brain injury: clinical challenges for successful translation. Brain Res. 2016;1640:94-103.

6. Singh V, Edwards NJ. Advances in the critical care management of ischemic stroke. Stroke Res Treat. 2013;2013, Article ID 510481, 7.

7. Vanden Hoek TL, Morrison LJ, Shuster M, et al. Part 12: cardiac arrest in special situations: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122:S829-861.

8. Dilip R. Neurological disorder in pregnancy. Crit Care Med. 2005;33:362-371.

9. Holzer M. Targeted temperature management for comatose survivors of cardiac arrest. N Engl J Med. 2010;363:1256-1264.

10. Donnino M, Chauhan A, Walsh M. Therapeutic hypothermia after cardiac arrest. N Engl J Med. 2011;364:187; author reply 187-188.

11. Jeejeebhoy FM, Zelop CM, Lipman S, et al. Cardiac arrest in pregnancy: a scientific statement from the American Heart Association. Circulation. 2015;132:1747.

12. Power GG, Blood AB. Perinatal thermal physiology. In: Polin R, Fox R, Abman SH, eds. Fetal and neonatal physiology. 4th ed. Philadelphia, PA: WB Elsevier Saunders, 2011. pp. 611-624.

13. Laburn HP, Faurie A, Goelst K, Mitchell D. Effects on fetal and maternal body temperatures of exposure of pregnant ewes to heat, cold, and exercise. J Appl Physiol. 2002;92:802-808.

14. Pardi G, Ferrari M, Lorio F, Acocella F, DVM, Boero V, Berlanda N et al. The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base balance. J Thorac Cardiovasc Surg. 2004;127:1728-1734.

15. Assali NS, Westin B. Effects of hypothermia on uterine circulation and on the fetus. Proc Soc Exp Biol Med. 1962;109:485-488.

16. Matsuki A, Oyama T. Operation under hypothermia in pregnant woman with an intracranial arteriovenous malformation. Can Anaesth Soc J. 1972;19:184-191.

17. Boatman KK, Bradford VA. Excision of an internal carotid aneurysm during pregnancy employing hypothermia and a vascular shunt. Ann Surg. 1958;148:271-275.

18. Jadhon ME, Main EK. Fetal bradycardia associated with maternal hypothermia. Obstet Gynecol. 1988;72:496-497.

19. Wentzel D, Viljoen KS, Botha JJ. Physiological and endocrinological reactions to cold stress in the angora goat. Agroanimalia. 1979;11:19-22.

20. Arias F. Cardiac disease and pregnancy. In: Arias F, editor. High-risk pregnancy and delivery. St Louis: Mosby Year Book; 1993. p. 312-29.

21. Souza MHL, Decio OE. Cardiopulmonary bypass in pregnant patients. Pregnancy and Cardiopulmonary Bypass. 2001;10:1-18.

22. Pomini F, Mercogliano D, Cavalletti C, et al. Cardiopulmonary bypass in pregnancy. Ann Thoracic Surg. 1996;61:259-268.

23. Pardi G, Tucci E, Uderzo A, Zanini D. Fetal electrocardiogram changes in relation to fetal heart patterns during labor. Am J Obstet Gynecol. 1974;118:243-250.

24. Shin’oka T, Shum-Tim D, Jonas RA, et al. Higher hematocrit improves cerebral outcome after deep hypothermic circulatory arrest. J Thorac Cardiovasc Surg. 1996;112:1610-1620.

25. Shin’oka T, Shum-Tim D, Laussen PC, et al. Effects of oncotic pressure and hematocrit on outcome after hypothermic circulatory arrest. Ann Thorac Surg. 1998;65:155-164.

26. Hoffenberg R, Louw J, Voss T. Thyroidectomy under hypothermia in a pregnant patient with thyroid crisis. Lancet. 1961;23:687-689.

27. Tanaka M, Ikeda T, Suzuki T, et al. A case of fetal bradycardia and sinusoid-like fetal heart rate pattern associated with maternal hypothermia. Fetal Diagn Ther. 1995;10:207-209.

28. Rittenberger J, Kelly E, Jang D, Greer K, et al. Successful outcome utilizing hypothermia after cardiac arrest in pregnancy: a case report. Crit Care Med. 2008;36:1354-1356.

29. Wible E, Kass J, López G. A report of fetal demise during therapeutic hypothermia after cardiac arrest. Neurocrit Care. 2010;13:239-242.

30. Chauhan A, Musunuru H, Donnino M, McCurdy MT, Chauhan V, Walsh M. The use of therapeutic hypothermia after cardiac arrest in a pregnant patient. Ann Emerg Med. 2012;60:786-789.

31. Oguayo KN, Oyetayo O. Successful use of therapeutic hypothermia in a pregnant patient. Tex Heart Inst J. 2015;42:367-371.

32. De Santis V, Negri M. Successful use of targeted temperature management in pregnancy after out-of-hospital cardiac arrest. Am J Emerg Med. 2016;34:122.e3-4.