Article information
RESUMEN
Objetivo
Revisar las indicaciones y las consideraciones de manejo perioperatorias de la terapia antiagregación plaquetaria (AAP).
MetodologíaCon las palabras clave "cirugía no cardiaca", "AAP" y "aspirina-clopidrogel" se hizo una búsqueda no sistemática en las bases de datos PubMed/Medline, SciElo.
ResultadosLa terapia de AAP se utiliza a menudo en el manejo de entidades médicas cardiovasculares y no cardiovasculares. Es importante asumir una posición clara con respecto a continuar, cambiar o suspender esta terapia en el contexto perioperatorio. Tal decisión debe fundamentarse en la valoración juiciosa del riesgo de sangrado y del riesgo de complicaciones perioperatorias secundarias a la suspensión del agente antiagregante que ha brindado al paciente condiciones adecuadas de manejo preoperatorias.
ConclusiónEn la mayoría de los escenarios de cirugía no cardiaca la suspensión de la aspirina en pacientes con enfermedad cardiovascular coronaria, cerebral o periférica debe evitarse si el riesgo de sangrado se considera leve o moderado.
Palabras clave::
Plaquetas
inhibidores de agregación plaquetaria
terapéutica
atención perioperativa. (Fuente: DeCS, BIREME).
Key words:
Blood platelets
platelet aggregation inhibitors
therapeutics
perioperative care. (Source: MeSH, NLM).
SUMMARY
Objective
To review the indications and perioperative management considerations for anti-platelet aggregation (APT) therapy.
MethodologyUsing "non-cardiac surgery", "APT" and "apirine-clopidogrel" as key words, a nonsystematic search was conducted in the PubMed/ Medline and SciELO databases.
ResultsAPT is used frequently for the management of cardiovascular and non-cardiovascular medical entities. It is important to adopt a clear stance regarding the continuation, change or withdrawal of this therapy in the perioperative context. That decision must be based on a judicious assessment of the risk of bleeding and the risk of perioperative complications secondary to the withdrawal of the antiplatelet agent that has offered the patient adequate management before surgery.
ConclusionIn most cases of non-cardiac surgery, withdrawal of aspirin in patients with coronary heart disease, cerebral or peripheral vascular disease must be avoided if the risk of bleeding is considered low or moderate.
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