Síndrome de fuga capilar sistémica: hipoalbuminemia, hemoconcentración y shock. A propósito de un caso

Muñoz-Guillén, N.M.; León‐López, Rafael; Cal-Ramírez, M.A. de la; Dueñas-Jurado, J.M.

doi:10.1016/j.semerg.2013.01.003

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…The high mortality of CLS patients is believed to be associated with the non-specific clinical manifestations and the rapid progression of these disorders in the acute-onset phase [2]. Dhir et al [3] found that the 5-year survival rate in CLS patients is approximately 70% and that 75% of the deaths occur in the acute-onset phase [4].…”

Section: Introductionmentioning

confidence: 99%

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Duan

Zhang

et al. 2017

Military Med Res

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Vascular leakage, or increased vascular permeability, is a common but important pathological process for various critical diseases, including severe trauma, shock, sepsis, and multiple organ dysfunction syndrome (MODS), and has become one of the most important causes of death for intensive care units (ICU) patients. Currently, although there has been some progress in knowledge of the pathogenesis of these vascular disorders, the detailed mechanisms remain unclear, and effective prophylaxis and treatment are still lacking. In this study, we aimed to provide a review of the literature regarding the regulatory mechanisms and prophylaxis as well as the treatment of vascular leakage in critical diseases such as severe trauma and shock, which could be beneficial for the overall clinical treatment of vascular leakage disorders.

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Section: Introductionmentioning

confidence: 99%

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Duan

Zhang

et al. 2017

Military Med Res

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“…Although the formation of microthrombi might prevent microorganisms from accessing tissue, it also further enhances tissue ischemia and organ damage, contributing to decreased antibiotic distribution [ 103 ]. However, it can also lead to capillary leakage, promoting an increase in tissue permeability [ 104 ]. Coagulopathy is also the hallmark of liver failure, an organ with a central role in clotting [ 105 ].…”

Section: Host Factorsmentioning

confidence: 99%

Biomarkers Predicting Tissue Pharmacokinetics of Antimicrobials in Sepsis: A Review

Codina

Jorda

2022

Clin Pharmacokinet

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The pathophysiology of sepsis alters drug pharmacokinetics, resulting in inadequate drug exposure and target-site concentration. Suboptimal exposure leads to treatment failure and the development of antimicrobial resistance. Therefore, we seek to optimize antimicrobial therapy in sepsis by selecting the right drug and the correct dosage. A prerequisite for achieving this goal is characterization and understanding of the mechanisms of pharmacokinetic alterations. However, most infections take place not in blood but in different body compartments. Since tissue pharmacokinetic assessment is not feasible in daily practice, we need to tailor antibiotic treatment according to the specific patient's pathophysiological processes. The complex pathophysiology of sepsis and the ineffectiveness of current targeted therapies suggest that treatments guided by biomarkers predicting target-site concentration could provide a new therapeutic strategy. Inflammation, endothelial and coagulation activation markers, and blood flow parameters might be indicators of impaired tissue distribution. Moreover, hepatic and renal dysfunction biomarkers can predict not only drug metabolism and clearance but also drug distribution. Identification of the right biomarkers can direct drug dosing and provide timely feedback on its effectiveness. Therefore, this might decrease antibiotic resistance and the mortality of critically ill patients. This article fills the literature gap by characterizing patient biomarkers that might be used to predict unbound plasma-to-tissue drug distribution in critically ill patients. Although all biomarkers must be clinically evaluated with the ultimate goal of combining them in a clinically feasible scoring system, we support the concept that the appropriate biomarkers could be used to direct targeted antibiotic dosing.

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“…entre 1979 y 1982. Una puntuación alta se correlacionó con gravedad y predicción de muerte hospitalaria 9 .…”

Section: Introductionunclassified

Índice de fuga capilar vs SOFA y APACHE II como predictor de mortalidad en sepsis por COVID-19

Ruiz-Ortega,

Alva-Arroyo,

Zapata-Chan

et al. 2023

REIE

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Introducción: La sepsis representa un problema de salud importante y afecta a millones de personas en todo el mundo, con un alto índice de mortalidad. Estratificar la predicción de mortalidad es una constante preocupación para establecer un tratamiento oportuno en el paciente. El síndrome de fuga capilar fue descrito por primera vez en 1960. Se han publicado menos de 150 casos en todo el mundo, con un incremento de los reportes en los últimos años. Objetivo: Predecir el desenlace en pacientes con sepsis por COVID-19, comparando índice de fuga capilar con las escalas de SOFA y APACHE II. Material y método: Evaluamos a 194 pacientes admitidos en Hospital del Estado de México de segundo nivel con diagnóstico de sepsis por COVID-19, confirmado por reacción de cadena de polimerasa-transcriptasa reversa (PCR-RT) para SARS-CoV-2. Resultado: Es un estudio retrospectivo, realizado en un centro único. Los pacientes que ingresaron con diagnóstico de sepsis por COVID-19 y presentaron puntaje de APACHE II > 25 tienen hasta tres veces mayor riesgo de morir a los 28 días. Con un IFC (índice de fuga capilar) > 80 tienen cuatro veces mayor riesgo de morir. El IFC obtuvo un hazard ratio [HR] p = 0.011), p = 0.001). Conclusiones: La fisiopatología de la inflamación y sus efectos a nivel endotelial han sido objeto de numerosos estudios tratando de asociar con mortalidad. En este estudio se identificó que el IFC es superior al SOFA y es un factor independiente de mortalidad.

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Síndrome de fuga capilar sistémica: hipoalbuminemia, hemoconcentración y shock. A propósito de un caso

Cited by 6 publications

References 10 publications

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Regulatory mechanisms, prophylaxis and treatment of vascular leakage following severe trauma and shock

Biomarkers Predicting Tissue Pharmacokinetics of Antimicrobials in Sepsis: A Review

Índice de fuga capilar vs SOFA y APACHE II como predictor de mortalidad en sepsis por COVID-19

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