SINDROME COMPARTIMENTAL





SINDROME COMPARTIMENTAL

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El síndrome compartimental requiere un alto índice de sospecha, un conocimiento adecuado de sus síntomas y signos clínicos y su confirmación mediante la medición de la presión intracompartimental.
constantinou9.jpg Autor:
c Constantinou
Columnista Experto de SIIC
Artículos publicados por c Constantinou
Coautor
George Velmahos, M.D., Ph.D.* 
University of Sothern California Keck School of Medicine*
Recepción del artículo
4 de Febrero, 2004
Primera edición
15 de Junio, 2004
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Las lesiones vasculares producen isquemia y su reparación produce la reperfusión. La isquemia y la reperfusión producen síndrome compartimental. Aunque es un evento local, este síndrome no arriesga sólo la extremidad afectada, sino también la vida del paciente. Su manejo se mejora mediante un alto índice de sospecha junto con un conocimiento adecuado de los síntomas clínicos sutiles (confirmados mediante la medición de la presión intracompartimental). Aunque los valores de CPK mayores a 5 000 U incrementan el riesgo de insuficiencia renal, la experiencia de casi 2 000 pacientes con valores anormales de CPK ingresados a la Unidad de Cuidados Intensivos de nuestra institución mostraron que el tratamiento con manitol/bicarbonato no reduce este riesgo, como tampoco previene la necesidad de diálisis o reduce la mortalidad, aunque existen algunas indicaciones de que puede ser beneficioso en pacientes con valores de CPK mayores a 30 000 U.

Palabras clave
Compartimental, lesiones vasculares, insuficiencia renal


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Abstract
Vascular injuries produce ischemia, and their repair produces reperfusion. Ischemia and reperfusion produce compartment syndrome. Although a local event, a compartment syndrome risks not only the affected extremity, but also the life of the patient. A high index of suspicion coupled with adequate knowledge of subtle clinical symptoms (and confirmed by intracompartmental pressure measurement), improve management of compartment syndrome. Although CPK values greater than 5 000 U increase the risk of renal failure, experience from almost 2 000 patients with abnormal CPK values that were admitted in the ICU in our center showed that treatment with mannitol/bicarbonate does not reduce that risk, neither does it prevent the need for dialysis nor does it reduce mortality. There are some indications though, that it may be beneficial in patients with CPK values greater than 30 000 U.

Key words
Compartment, vascular injuries, renal failure


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Clasificación en siicsalud
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Especialidades
Principal: Ortopedia y Traumatología
Relacionadas: Medicina Interna, Nefrología y Medio Interno



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Bibliografía del artículo
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Título español
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 Artículo completo
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 Autoevaluación
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