Manejo de hemorragia digestiva y anticoagulación en tiempos de COVID - 19

Digestive bleeding and anticoagulation management in times of COVID - 19

Palabras clave: Sangrado gastrointestinal, COVID-19, anticoagulación

Resumen

El sangrado gastrointestinal (SGI) en pacientes con SARS-CoV-2 plantea desafíos únicos. Aunque los resultados de ensayos controlados para demostrar el beneficio de la anticoagulación empírica están pendientes, los centros médicos han propuesto la anticoagulación en dosis intermedia y terapéutica, particularmente aquellos con niveles elevados de dímero D, con el fin de prevenir complicaciones tromboembólicas potencialmente catastróficas. En pacientes con hemorragia digestiva se recomienda iniciar medidas de reanimación, Inhibidor de bomba de protones, transfusiones de hemoderivados y retirada de anticoagulantes. En sospecha de hemorragia relacionada con hipertensión portal, se recomienda tratar de acuerdo con las pautas estándar: reanimación, fármacos vasoconstrictores  esplácnico, concentrados de glóbulos rojos para mantener una hemoglobina objetivo de 7 a 8 g/dL, inhibidor de la bomba de protones administrado en forma de perfusión o inyecciones dos veces al día, antibióticos como profilaxis primaria, Vitamina K, antifibrinolíticos y retirada de los anticoagulantes. Igualmente se sugiere estricto seguimiento hemodinámico para cualquier evidencia de sangrado persistente.

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Publicado
2021-05-04
Cómo citar
Dias De Oliveira, C. M. (2021). Manejo de hemorragia digestiva y anticoagulación en tiempos de COVID - 19: Digestive bleeding and anticoagulation management in times of COVID - 19. Revista Profesional HígadoSano, (20), 16-19. Recuperado a partir de https://produccioncientificaluz.org/index.php/higadosano/article/view/35798
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