Utilidad de la terapia de acuaféresis. Artículo de revisión

  • Diana Ávila Universidad tecnológica de Pereira, Colombia
  • Andrés Bernal Departamento Medicina Crítica, Servicio de Nefrología, Empresa Social del Estado Hospital Universitario San Jorge, Pereira
  • José Fernando Gómez Unidad de Cuidados Intensivos, Departamento Medicina Crítica. Clínica Los Rosales, Pereira https://orcid.org/0000-0001-9773-2192
Palabras clave: Ultrafiltración; Falla cardiaca; Sobrecarga fluidos; Síndrome cardiorrenal; Injuria renal aguda; Diálisis; Terapia extracorpórea; Cuidado crítico.

Resumen

Introducción

La terapia de acuaféresis ha sido estudiada como una herramienta terapéutica para pacientes con sobrecarga de volumen refractaria al tratamiento con diuréticos del ASA. Su objetivo principal es mitigar el impacto clínico de esta sobrecarga en los pacientes con insuficiencia cardiaca descompensada y síndrome cardiorrenal, reconociendo de esta manera los balances acumulados positivos en los pacientes críticamente enfermos como un factor independiente de mortalidad. Realizamos una revisión sobre los principios teóricos de la terapia de acuaféresis y los resultados a la luz de la evidencia actual. Se hizo una búsqueda en las principales bases de datos científicas sobre la terapia de acuaféresis. Se incluyeron artículos de revisión, guías de manejo y estudios dentro de los que se incluyen ensayos clínicos controlados, revisiones sistemáticas y meta-análisis con las palabras clave MeSH. Se encontraron referencias bibliográficas en bases de datos Web of Sciences/Scopus/PubMed/SciELO desde 2005 hasta 2017. La acuaféresis es una terapia de ultrafiltración patentada que mejora la sobrecarga refractaria en pacientes con insuficiencia cardiaca congestiva. Hay brechas en el conocimiento en relación a su costo-efectividad, a los eventos adversos graves que se le atribuyen y a los candidatos beneficia, por tanto, se requieren más estudios de calidad para llegar a conclusiones sólidas. Hasta el momento no hay evidencia contundente que respalde la terapia de acuaféresis para implementar su uso sistemático y rutinario de la unidad de cuidados intensivos.

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Referencias

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Publicado
2020-01-08
Cómo citar
1.
Ávila D, Bernal A, Gómez JF. Utilidad de la terapia de acuaféresis. Artículo de revisión. Rev. Colomb. Nefrol. [Internet]. 8 de enero de 2020 [citado 28 de marzo de 2020];7(1). Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/365
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Artículo de revisión