Retos en el enfrentamiento del shock hipovolémico en el paciente politraumatizado
DOI:
https://doi.org/10.55204/trc.v4i1.e364Palabras clave:
Shock hemorrágico, paciente politraumatizado, reanimación con control de dañosResumen
Durante el reconocimiento y tratamiento de la hemorragia, que puede resultar potencialmente mortal en el paciente politraumatizado, se presentan desafíos para los profesionales en las diferentes etapas de la atención médica. Se realizó una revisión de la fisiopatología del shock hemorrágico y de las estrategias actuales de la conducta ante la pérdida aguda de sangre secundaria a trauma. En este sentido, se hizo énfasis en las lesiones que pueden pasar desapercibidas en la evaluación inicial y en la aparente compensación fisiológica. Se abordaron aspectos controversiales relacionados con la decisión en cuanto al momento oportuno y el modo adecuado de iniciar correctamente la reanimación con control de daños para evitar el empeoramiento de los trastornos graves inherentes a esta condición, como la acidosis y la coagulopatía inducida por el trauma y sus estados de hipo o hipercoagulabilidad (trombótico). Se evaluó la controversia sobre la composición de los componentes que se transfunden durante la reanimación con control de daños, que justifica la tendencia en la práctica médica de transfundir con mayor frecuencia plasma liofilizado, en comparación con la de plasma fresco congelado compatible con ABO.
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Derechos de autor 2024 María Fernanda Torres Proaño , Erika Adriana Madrid Peralta, Diego Alexander Hermida Pareja, Katherine Isabel Bravo Orellana, Víctor Manuel Sellan Bustamante
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