Información del artículo
Resumen
La respuesta del organismo a la agresión quirúrgica incluye no sólo una marcada reducción de la sensibilidad a la acción de la insulina, con la consecuente hiperglucemia, sino también alteraciones en los valores plasmáticos de lípidos, ácidos grasos, aminoácidos y proteínas, y de las moléculas involucradas en la respuesta inflamatoria, como interleucinas, calicreína y factores de coagulación. La resistencia a la insulina se desarrolla prácticamente en respuesta a cualquier tipo de agresión quirúrgica, y existe evidencia creciente de que no es beneficiosa para la evolución postoperatoria. Estudios recientes han mostrado que el ayuno induce un estado metabólico que no es favorable para los pacientes sometidos a cirugía programada. La resistencia a la insulina postoperatoria puede minimizarse si el estado de ayuno preoperatorio se sustituye por una carga de hidratos de carbono, administrados por vía oral o intravenosa.
Palabras clave:
Agresión
Hiperglucemia
Resistencia a la insulina
Postoperatorio
Glucosa
The body’s response to surgical aggression includes not only a marked reduction in sensitivity to the action of insulin with subsequent hyperglycemia, but also alterations in plasma levels of lipids, fatty acids, amino acids and proteins, as well as in the molecules involved in inflammatory response such as interleukins, kallikrein and coagulation factors. Insulin resistance (IR) is present after practically all surgical stresses. Increasing evidence suggests that this response is not beneficial to postoperative outcome. Recent studies show that fasting creates an unfavorable metabolic status in patients scheduled to undergo surgery. Replacing fasting with a carbohydrate load administered orally or intravenously can minimize IR.
Key words:
Aggression
Hyperglycemia
Insulin resistance
Glucose
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