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Los efectos hemodinámicos de la traquea en comparación con la adrenalina intravenosa
1Department of Anaesthetics, Derriford Hospital, Plymouth, Devon, UK.
Lancet (London, England)
|October 10, 1992
Resumen
La adrenalina traqueal, incluso en dosis dos veces la cantidad intravenosa, no mostró efectos hemodinámicos significativos en un estudio de pacientes con paro cardíaco. Se pueden necesitar dosis más altas para la eficacia durante la reanimación.
Área de la Ciencia:
- Cardiología Cardiología.
- Medicina de emergencia Medicina de emergencia.
- Farmacología Farmacología.
Sus antecedentes:
- El acceso intravenoso es crucial para la administración de fármacos durante la resucitación cardiopulmonar.
- La administración traqueal de adrenalina es una alternativa cuando el acceso intravenoso no está disponible.
- Las recomendaciones actuales sugieren una dosis traqueal el doble de la dosis intravenosa.
Objetivo del estudio:
- Para investigar los efectos hemodinámicos de las dosis bajas de traquea frente a la adrenalina intravenosa.
- Para evaluar la eficacia de las actuales recomendaciones de dosificación de adrenalina traqueal.
Principales métodos:
- Un estudio cruzado aleatorizado que involucró a 12 pacientes anestesiados sometidos a reemplazo de cadera.
- Los pacientes recibieron adrenalina por vía intravenosa (0,1 microgramos/kg) y por vía traqueal (0,5 microgramos/kg) en administraciones separadas.
- Se monitorearon los parámetros hemodinámicos, incluida la presión arterial sistólica y la frecuencia cardíaca.
Principales resultados:
- La adrenalina intravenosa (0,1 microgramos / kg) aumentó significativamente la presión arterial sistólica en una media de 40,5 mm Hg con un cambio mínimo en la frecuencia cardíaca.
- La adrenalina traqueal (0,5 microgramos / kg) no demostró ningún efecto significativo en la presión arterial o la frecuencia cardíaca.
- Las dosis bajas de adrenalina traqueal carecen de un impacto hemodinámico medible.
Conclusiones:
- La dosis traqueal recomendada de adrenalina (el doble de la dosis intravenosa) es probablemente ineficaz para el tratamiento del paro cardíaco.
- Se pueden requerir dosis traqueales más altas, potencialmente diez veces la dosis intravenosa, basadas en estudios en animales.
- Se necesita más investigación para establecer una dosis efectiva de adrenalina traqueal para la reanimación.
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