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2019, Número 1

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RCAN 2019; 29 (1)


Sobre el lugar y la efectividad de los ácidos grasos w3 en la Nutrición artificial

Matos AA

Idioma: Español
Referencias bibliográficas: 89
Paginas: 167-190
Archivo PDF: 564.71 Kb.


RESUMEN

Las propiedades farmacológicas de los ácidos grasos poliinsaturados (AGPI) de la serie ώ3 (AGώ3) han sido explotadas en diversas aplicaciones de la Nutrición artificial. Los AG3 se han incorporado en preparaciones enterales empleadas como adyuvantes de la citorreducción tumoral y la contención de la inflamación, la sepsis y la injuria. Los AGώ3 también se han utilizado como soluciones parenterales en situaciones clínico-quirúrgicas metabólicamente complejas como el trauma, la quemadura, y la injuria pulmonar aguda. La efectividad de los AGώ3 como agentes farmacológicos vehiculados en una matriz nutrimental se ha establecido mediante modelos in vitro, tras experimentación animal, y gracias a estudios en voluntarios sanos. La efectividad de los AGώ3 también se ha medido del acortamiento de la estadía hospitalaria, la reducción de la duración de la ventilación mecánica, y la disminución del uso de antibióticos; en los pacientes críticamente enfermos, o aquellos que evolucionan después de una cirugía de elevado impacto nutricional. Los AGώ3 pueden aminorar la respuesta inflamatoria sistémica desatada tras la agresión, y proteger al endotelio y el alvéolo del daño pro-inflamatorio y pro-oxidante, asegurando así una mejor perfusión tisular por un lado, y una mejor ventilación e intercambio de gases, por el otro. La administración de las soluciones parenterales de AGώ3 (como especies químicas únicas o combinadas con otras familias de AGPI) es segura, y se asocia a una baja tasa de complicaciones. La efectividad de las preparaciones enterales que incorporan AGώ3 depende de las características del régimen de infusión, la vía de administración que se emplee, la dosis a instilar, la constancia del medio interno, y la tolerancia del enfermo. Lo anteriormente dicho no presupone que los AGώ3 sean universalmente efectivos. Los grupos básicos de trabajo deben elaborar pautas locales que sean trazables hasta las recomendaciones de los cuerpos de expertos y las sociedades profesionales para la elección del mejor momento del uso de un producto que contiene AGώ3, la definición de los objetivos terapéuticos a alcanzar con el mismo, las condiciones para el uso seguro, el seguimiento regular, y la verificación del impacto logrado. Matos Adames A. Sobre el lugar y la efectividad de los ácidos grasos ώ3 en la Nutrición artificial. RCAN Rev Cubana Aliment Nutr 2019;29(1):167-190. RNPS: 2221. ISSN: 1561-2929.


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