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inglés al español: Natriuretic Peptides General field: Medicina Detailed field: Biología (biotecnología/química, microbiología)
Texto de origen - inglés
Introduction
IB-type natriuretic peptide is a cardiac neurohormone secreted by the cardiac ventricules that uses the GMPc as a second messenger. Its half-life in plasma is approximately 20 minutes. In healthy adults, its concentration varies between 7 and 15 pg/ml. Due to its biological effects (natriuresis, diuresis, vasodilatation) and inhibition of the renin-angiotensin-aldosterone system) it can behave differently over the cardiovascular system. For this reason, it is a useful tool when predicting hemodynamic complications in a cardiac surgery
Objectives
The aim of this study is to recognize the importance of plasma BNP levels before the surgery to predict possible complications during the immediate postoperative recovery after a cardiovascular surgery: low cardiac output syndrome , cardiogenic shock and therapy recovery time longer than 48 hours.
Methods and materials
During a period of 6 months (from November 2004 until April 2005), 60 patients that had been subjected different surgeries were studied prospectively . 30 patients had been subjected to Miocardial revascularization surgery (RM) .16 patients had been subjected to valvular replacement surgery (VR) and 14 patients had been subjected to both surgeries combined /RM and RV) .
All these procedures were elective, making use of extracorporeal circulation and cardioplegic arrest (introduced by Buckberg). The patients were heparinized systematically with 3 mg/kg of sodium heparine to maintain an active coagulation period longer than 400 m/seg.
Protamine was used in a ratio of 1:1 to reverse the heparine. The anesthesia was applied equally to all the patients. The narcosis was maintained with combined techniques ( inhalation and intravenous anesthesia). In all the cases a catheter was used in the pulmonary artery for hemodynamic evaluation (Swan Ganz). The monitoring was completed with a continuous register of blood pressure and cardiac rhythm associated with the seriated controls of arterial gasometry, endo medium and urinary volume.
Traducción - español INTRODUCCION
El peptido natriurético cerebral (BNP) es una hormona cardíaca sintetizada predominantemente por los miocitos ventriculares que utiliza al GMPc como 2º mensajero. Su vida media en plasma es de aproximadamente 20 minutos y en adultos sanos su concentración oscila entre 7 y 15 pg/ml. Debido a sus efectos biológicos (natriuresis, diuresis, vasodilatación e inhibición del sistema renina- angiotensina-aldosterona) posee una amplia variedad de acciones sobre el sistema cardiovascular, por lo cual es una herramienta con funciones regulatorias que puede ser utilizada en el ámbito de la cirugía cardíaca como predictor de complicaciones hemodinámicas.
OBJETIVOS
El objetivo del siguiente estudio fue valorar la utilidad del nivel plasmático de BNP preoperatorio como predictor de complicaciones en el postoperatorio inmediato de cirugía cardiovascular: síndrome de bajo volumen minuto, shock cardiogénico y estadía en terapia > de 48 hs.
MATERIAL Y METODOS
Durante un período de 6 meses (noviembre de 2004 a abril de 2005), se incluyeron en el estudio en forma prospectiva 60 pacientes que fueron sometidos a cirugía de revascularización miocárdica (CRM) (30 p), cirugías de reemplazo valvular (RV) (16 p) y procedimientos combinados (CRM RV) (14 p).
Todos estos procedimientos fueron electivos, con utilización de circulación extracorpórea y paro cardiopléjico con técnica de Buckberg. Los pacientes fueron heparinizados en forma sistémica con 3 mg/kg de heparina sódica para mantener durante la circulación extracorpórea un tiempo de coagulación activado (ACT) mayor de 400 m/seg.
Se utilizó protamina en relación 1:1 para revertir la heparina. El manejo anestésico fue uniforme en todos los pacientes, la narcosis fue mantenida con técnicas combinadas (anestésicos inhalatorios y endovenosos) y en el 100% de los casos se utilizó un catéter en la arteria pulmonar para valoración hemodinámica (Swan Ganz). El monitoreo se completó con un registro continuo de presión arterial y ritmo cardíaco asociado con controles seriados de gasometría arterial, medio interno y volumen urinario.
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Formación en el ámbito de la traducción
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Experiencia
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