Prevención del Síndrome Postcardiotomía Tras Cirugía Cardíaca
El síndrome postcardiotomía — que engloba el síndrome postpericardiotomía y el derrame pericárdico o pleural asociado — es una complicación reconocida de la cirugía cardíaca. Una estrategia profiláctica perioperatoria es fundamental para reducir su incidencia y las complicaciones derivadas.
Enfoque clínico
La profilaxis antiinflamatoria se inicia en torno al momento de la cirugía cardíaca. El protocolo especifica qué agentes utilizar, cuándo debe comenzar el tratamiento en relación con la intervención y durante cuánto tiempo debe mantenerse — los detalles están disponibles en el régimen completo a continuación.
Objetivos del tratamiento
- Reducción o ausencia del síndrome postpericardiotomía
- Prevención del derrame pericárdico
- Prevención del derrame pleural
- Prevención del taponamiento cardíaco
- Ausencia de fibrilación auricular a las 72 horas del postoperatorio
References
DOI: 10.1007/s10557-021-07261-4
- The weight-adjusted colchicine dosage was 0.5 mg/kg in three studies and 1 mg daily in two studies.
- The duration of colchicine treatment was between 14 and 30 days.
- Indomethacin dosage was 25 mg 3 times/day for three days before surgery in one trial.
- Treatment duration lasted for 6 weeks after the surgery.
- Given their low adverse effects rates, clinical administration of colchicine and indomethacin in the preoperative setting could be considered an optimal solution to prevent PPS and PE.
- The authors' conclusions indicated indomethacin as an alternative to other drugs to avoid postoperative PE.
- Primary endpoints were related to registering the reduction of pericardial and pleural effusion in all the studies examined, while there was no homogeneity with secondary endpoints in the study groups.
- The secondary endpoints were to assess the effectiveness of the three drugs in reducing hospital readmission, cardiac tamponade, symptom persistence, and atrial fibrillation after 72 h, as well as the safety and adverse effects of pharmacological treatment.