Impacto de intervenciones para el manejo del embolismo aéreo cerebral masivo en cirugía de bypass cardiopulmonar

Autor: Quintero López, Olga Lucía
Přispěvatelé: Giraldo Bustamante, Juan Camilo, Sandoval, Nestor
Jazyk: Spanish; Castilian
Rok vydání: 2018
Předmět:
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Repositorio EdocUR-U. Rosario
Universidad del Rosario
instacron:Universidad del Rosario
DOI: 10.1186/2046-4053-4-
Popis: Antecedentes: El embolismo aéreo masivo cerebral durante circulación extracorpórea en cirugía cardiaca es una complicación catastrófica. Su incidencia es rara y oscila alrededor del 0.1 a 0.2% (1) y sus efectos pueden ser devastadores o letales (2,3). No existe en la literatura un algoritmo unificado o un estándar de cuidado establecido que agrupe las distintas conductas que buscan evitar o reducir las repercusiones clínicas en el paciente que presenta esta complicación (4). Metodología: Revisión sistemática cualitativa y meta-análisis. Se seguirá la guía PRISMA- P para la elaboración, redacción y publicación del protocolo de revisión sistemática (5). Resultados: Se identificaron 2066 artículos, de los cuales se obtienen 135 posibles artículos basados en el título y abstract. Posteriormente, se exploran los abstracts de estos 135 artículos y sólo 33 son elegibles para evaluación de su texto completo para ser considerados para el metaanálisis. Finalmente se obtienen 29 artículos corresponidientes a reportes y series de caso sobre el manejo de embolismo aereo masivo durante circulació n extracorpórea y 2 artículos para ser metaanalizados. Conclusión: La mejor estrategia de manejo para una complicación de estas características es su prevención. Sin embargo, es inminente que alguna vez nos veamos enfrentados a su ocurrencia. No se deben escatimar esfuerzos en estrategias costo efectivas para su detección temprana, y se debe establecer un protocolo de manejo claro, conciso y multimodal. Background: Massive cerebral air embolism during cardiopulmonary bypass (CPB) is catastrophic and in some instances, has the potential to lead to fatal outcomes. Its incidence is around 0.1% to 0.2% % (1) and secuelae of it can be devastating and in some instances fatal (2,3). There is not an evidence-based algorithm for the diagnosis and intraoperative management of this complication (4). Methodology: Qualitative systematic review and meta-analysis. PRISMA-P guidelines will be followed for the elaboration, redaction, and publication of the protocol (5). Results: Two thousand and sixty six articles were identified. Of these, 135 possible articles were considered for analysis of title and abstract. Thirty-three articles were retrieved for full text review. Of these, two articles were excluded since they did not met inclusion criteria. Two articles were included for meta-analysis and 29 case reports and series were included for description. Conclusion: The best management strategy for a complication of this type is prevention. Nevertheless, a surgical team may ultimately be confronted with such an occurrence at some point despite all the prevention strategies, as was the case with our patient. That is why, in each institution, no effort should be spared to establish cost-effective strategies for early detection and a clear and concise management protocol to guide actions once this complication is detected.
Databáze: OpenAIRE
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