Manejo perioperatorio de la farmacoterapia crónica en cirugía cardiaca: revisión bibliográfica y recomendaciones
DOI:
https://doi.org/10.51481/amc.v67i4.1477Palabras clave:
atención perioperatoria, cirugía cardiaca, farmacología, puente de arteria coronaria, circulación extracorpórea, puente cardiopulmonarResumen
La optimización de la terapia farmacológica preoperatoria en cirugía cardíaca es esencial para reducir complicaciones perioperatorias y mejorar los resultados clínicos. Diversos fármacos utilizados de manera crónica, como inhibidores de la enzima convertidora de angiotensina, antagonistas del receptor de angiotensina II, anticoagulantes, antiplaquetarios, betabloqueadores, diuréticos e hipoglucemiantes orales tienen implicaciones significativas en el contexto de la cirugía cardíaca, particularmente por su interacción con la circulación extracorpórea.
Estos medicamentos pueden asociarse a eventos adversos como lesión renal aguda, síndrome vasopléjico, sangrado postoperatorio y disfunción multiorgánica, lo que subraya la importancia de su manejo cuidadoso. El objetivo de esta revisión es analizar la evidencia más reciente sobre el manejo perioperatorio de estos fármacos, además destacar las recomendaciones clave basadas en la mejor evidencia disponible. Aunque no existe un protocolo universal, el enfoque debe ser multidisciplinario, adaptado a las características clínicas del paciente, el tipo de cirugía y las comorbilidades. La implementación de estrategias adecuadas puede mitigar complicaciones y mejorar los resultados quirúrgicos en este grupo de alto riesgo.
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