Transfusiones de glóbulos rojos en pacientes críticos

Carolina Ruiz Balart

doi:10.11565/arsmed.v42i3.935

Autores/as

Carolina Ruiz Balart Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile. UCI Complejo Asistencial Dr Sotero del Rio.

DOI:

https://doi.org/10.11565/arsmed.v42i3.935

Palabras clave:

Anemia, glÃ³bulos rojos, transfusiÃ³n, enfermedad crÃtica, hemoglobina, unidad de cuidados intensivos.

Resumen

La anemia es muy frecuente en los pacientes críticos,Â pudiendo estar presente en casi el 100% después una semana de hospitalización enla Unidadde Cuidados Intensivos (UCI). Se ha descrito que la anemia es un factor de riesgo de mayor mortalidad y morbilidad para los pacientes críticos. La etiología de la anemia en UCI es multifactorial, destacando la anemia de la inflamación, los déficits nutricionales, la hemodilución y el aumento de las pérdidas. Dentro del aumento de las pérdidas destaca la toma seriada de exámenes de sangre.

A pesar de lo deletéreo de la anemia, no se ha demostrado que las transfusiones de glóbulos rojos (GR) puedan mejorar el pronóstico de los pacientes con anemia. Por el contrario, hay estudios que han descrito un aumento de las complicaciones y mortalidad asociadas al aporte de GR. La evidencia actual sugiere que en pacientes críticos estables y que no presentan sangrado activo, las transfusiones deberían evitarse si la concentración de hemoglobina es mayor a 7 g/dL. Sin embargo, un umbral transfusional estricto puede no ser adecuado para todos los pacientes, por lo que también deberían considerarse las alteraciones de la perfusión y la condición cardíaca y respiratoria en la decisión de transfundir GR.

Biografía del autor/a

Carolina Ruiz Balart, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile. UCI Complejo Asistencial Dr Sotero del Rio.

Prof Asistente Medicina Intensiva PUC

Jefe Técnico UCI CASR

Citas

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