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Anti-digoxina fragmentos de Fab en la cardiotoxicidad inducida por la ingestión de oleandra amarilla: un ensayo
M Eddleston1, S Rajapakse, Rajakanthan
1Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, UK.
Lancet (London, England)
|April 18, 2000
Resumen
Los fragmentos de Fab anti-digoxina tratan eficazmente las arritmias cardíacas inducidas por el oleandro amarillo, mejorando el ritmo y la frecuencia cardíaca. Este tratamiento ofrece una alternativa segura a la transferencia de pacientes, reduciendo potencialmente la mortalidad en las zonas rurales de Sri Lanka.
Área de la Ciencia:
- Toxicología Toxicología.
- Cardiología Cardiología.
- Farmacología Farmacología.
Sus antecedentes:
- La ingestión de semillas de oleandro amarillo causa una grave cardiotoxicidad en Sri Lanka.
- El manejo actual requiere la transferencia del paciente para el ritmo cardíaco temporal.
- Un ensayo controlado aleatorizado investigó el antidigoxin Fab para las arritmias inducidas por oleander.
Objetivo del estudio:
- Evaluar la eficacia de la anti-digoxina Fab en la reversión de las arritmias cardíacas graves causadas por la ingestión de oleandro amarillo.
- Evaluar la seguridad y eficacia del anti-digoxina Fab como tratamiento en entornos sanitarios rurales.
Principales métodos:
- Un ensayo controlado aleatorizado en el que participaron 66 pacientes con arritmias cardíacas graves.
- Los pacientes recibieron 1200 mg de anti-digoxina Fab o una solución salina y un placebo.
- Se recogieron electrocardiogramas y muestras de sangre para controlar el ritmo cardíaco, los electrolitos y los niveles de glucósidos.
Principales resultados:
- El anti-digoxina Fab resuelve significativamente las arritmias más rápido que el placebo (p<0.001).
- Una mayor proporción de pacientes tratados con anticuerpos lograron el ritmo sinusal dentro de las 8 horas (p <0,001).
- El tratamiento con anti-digoxina Fab condujo a un aumento de la frecuencia cardíaca y la disminución de los niveles séricos de potasio.
Conclusiones:
- Los fragmentos de anti-digoxina Fab son un tratamiento seguro y eficaz para las arritmias cardíacas inducidas por oleandro amarillo.
- Esta intervención puede reducir potencialmente las transferencias de pacientes y la mortalidad en los hospitales rurales de Sri Lanka.
- Se necesitan más estudios para confirmar la reducción de las tasas de mortalidad.
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