Resumen
El sindrome de respuesta inflamatoria responde actualmente a múltiples causas y su tratamiento tiene implicacias pronósticas. Uno de los pilares es la reanimación precoz con fluidos con el objeto de restablecer las variables macro y microhemodinámias determinantes desarrollo de hipoperfusión tisular. En este sentido, la persistencia de hipoxia tisular resulta en sindrome de disfunción multiorgánica, principal causa de mortalidad en los pacientes criticos.
Recientemente ha surgido un interés creciente en los efectos de la acidosis metabólica hiperclorémica generada por el uso exagerado de soluciones no balanceadas y la elevada prvalencia de acidosis dilucional en este grupo de pacientes. Existe evidencia experimental y clinica que demuestra los efectos deletereos del exceso del Cl- en esta población incrementando citoquinas pro inflamatorias y modificando la circulacóón orenal. De modo que en la siguiente revisión me propongo revisar la fisiología del ion Cl- y la evidencia experimental y clínica reelevante a la fecha.
Citas
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