Medicina evolucionista en terapia intensiva: un nuevo paradigma


  • Juan Ignacio Padilla Cuadra Caja Costarricense del Seguro Social, Hospital Dr. Rafael A. Calderón Guardia


Palabras clave:

medicina evolucionistaterapia intensiva, enfermedad, adaptación


Los avances tecnológicos han permitido la supervivencia de pacientes críticamente enfermos que hubieran fallecido de manera inevitable. No obstante, muchas de las medidas de este tratamiento intensivo son riesgosas y con un alto costo material y de esfuerzo humano. La medicina evolucionista es una tendencia mundial que propone que un alto número de alteraciones del paciente corresponden a respuestas de adaptación con el objetivo de la supervivencia y no requieren obligatoriamente de su normalización. En el caso del paciente críticamente enfermo, este enfoque es innovador y podría conducir a una medicina crítica orientada al reconocimiento de estas respuestas adaptativas y su modulación. Esta nueva forma de interpretar las manifestaciones de la enfermedad puede tener importantes repercusiones en su tratamiento y una utilización más racional de los recursos. La aplicación de este paradigma puede mejorar los resultados hasta ahora no óptimos, en condiciones como shock séptico, en las que medidas consideradas como lógicas o racionales han sido inefectivas. Se presenta una revisión sobre los principios de esta tendencia, evidencia que la apoya, algunas hipótesis sobre su aplicación en casos concretos y sus limitaciones.


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2018-01-04 — Actualizado el 2018-01-04


Cómo citar

Cuadra, J. I. P. (2018). Medicina evolucionista en terapia intensiva: un nuevo paradigma. Acta Médica Costarricense, 60(1), 7–14.