Critérios prognósticos: paciente comatoso e controle direcionado de temperatura
DOI:
https://doi.org/10.34024/rnc.2022.v30.13361Palavras-chave:
controle direcionado de temperatura, parada cardíaca, unidade de terapia intensiva, coma, prognóstico, lesão de reperfusãoResumo
Introdução. O Controle Direcionado de Temperatura é utilizado, principalmente, para reduzir lesões de reperfusão em pacientes vítimas de parada cardíaca internados em Unidade de Terapia Intensiva que permanecem comatosos após a ressuscitação e o retorno da circulação espontânea. Objetivo. Discutir a avaliação do prognóstico de pacientes comatosos que foram submetidos ao Controle Direcionado de Temperatura após uma parada cardiorrespiratória, haja vista que esta abordagem terapêutica poderia alterar tanto a acurácia quanto os valores de corte dos parâmetros normalmente utilizados. Método. Trata-se de revisão integrativa com abordagem qualitativa. Na busca, foram utilizadas as palavras-chave “ICU”, “induced hypothermia”, “Targeted Temperature Management”, “cooling”, “cardiac arrest” e “prognosis”. A análise incluiu estudos primários publicados a partir de 2010 envolvendo diferentes testes clínicos e laboratoriais prognósticos nesse contexto, verificando suas aplicabilidades práticas atuais. Resultados. A terapia com controle direcionado de temperatura de fato interfere na validade dos testes atualmente empregados e nos seus respectivos parâmetros de referência. Conclusões. Torna-se imprescindível uma avaliação combinada de diferentes exames (multiparamétrica), bem como realização de testes clínicos randomizados e estudos em maiores escalas, de forma a guiar a criação de uma diretriz clara e atualizada para esse grupo específico de pacientes.
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Copyright (c) 2022 Thaís Soares Corrêa, Lucas Vilas Bôas Magalhães
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Aceito: 2022-09-01
Publicado: 2022-10-18
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