Síndrome de implantación del cemento oseo (SICO). Alteraciones hemodinámicas. Reporte de un caso
Abstract
El cemento consta de dos componentes, uno líquido compuesto en un 97,4 % por monómero de metilmetacrilato y otro en polvo compuesto por polímero de metilmetacrilato, componentes coactivadores. Durante su fase de mezclado se produce una reacción exotérmica que alcanza los 110ºC, posible factor promotor de parada cardiaca, complicación extrema por estimulación neurogénica. El diagnóstico del SICO se realiza por las alteraciones hemodinámicas que se presentan durante la fase de implantación del cemento, que pueden variar desde hipotensión transitoria, arritmias, infarto agudo del miocardio, accidente cerebrovascular, embolismo pulmonar y parada cardiorrespiratoria. La terapéutica está encaminada a evitar la aparición del mismo, valorando intervenciones quirúrgicas alternativas en pacientes de riesgo y realizando una preparación preoperatoria cuidadosa. En este trabajo se presenta un caso de una anciana de 74 años de edad que ingresó en el Hospital General Provincial Docente “Roberto Rodríguez Fernández” para practicarle un Reemplazo Protésico Parcial Cementado, presentando alteraciones hemodinámicas durante el mismo compatibles con el SICO. Se describen las características clínicas del paciente y se destaca el manejo anestésico.Downloads
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