Efecto modulador del esmolol sobre la respuesta inflamatoria local secundaria a la ventilación unipulmonar en un modelo experimental de cirugía torácica
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2024
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19/05/2025
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Universidad Complutense de Madrid
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Abstract
El daño pulmonar agudo secundario a la cirugía de resección pulmonar (LRS) es una de las principales causas de complicaciones respiratorias en los pacientes que se someten a esta intervención. Conlleva una importante morbi-mortalidad tanto inmediata como a largo plazo. En la fisiopatología de esta entidad destacan factores como la hiperactivación simpática perioperatoria, la ventilación unipulmonar (OLV) y los fenómenos de isquemia reperfusión(I/R). Todos estos factores se entrelazan generando una respuesta inflamatoria secundaria que de manera directa y a través de la activación de las vías de la apoptosis, acaba lesionando la barrera alveolo-capilar y provocando la acumulación de edema en los alveolos. El esmolol es un fármaco beta-bloqueante (BB) con efectos anti-catecolaminérgicos, antiinflamatorios y antioxidantes, de fácil uso por su perfil farmacocinético y farmacodinámico, en el periodo perioperatorio...
Acute lung injury following lung resection surgery (LRS) is one of the main causes of respiratory complications in patients submitted to this surgical procedure. It carries a great amount of morbidity and mortality both in the short and long term. In the physiopathology behind this entity, factors like perioperative catecholaminergic response, one-lung ventilation and ischemia-reperfusion injury play a significant role. All these factors work together generating a secondary inflammatory response which in both, directly and through apoptosis pathways activation, end up injuring the alveolo-capillary barrier and causing the alveolus to be filled with protein-rich edema. Esmolol is a beta-blocker (BB) drug with anti-catecholaminergic, anti-inflammatory and antioxidant effects. Its pharmacokinetic and pharmacodynamic profile makes it the mostsuitable for the perioperative setting...
Acute lung injury following lung resection surgery (LRS) is one of the main causes of respiratory complications in patients submitted to this surgical procedure. It carries a great amount of morbidity and mortality both in the short and long term. In the physiopathology behind this entity, factors like perioperative catecholaminergic response, one-lung ventilation and ischemia-reperfusion injury play a significant role. All these factors work together generating a secondary inflammatory response which in both, directly and through apoptosis pathways activation, end up injuring the alveolo-capillary barrier and causing the alveolus to be filled with protein-rich edema. Esmolol is a beta-blocker (BB) drug with anti-catecholaminergic, anti-inflammatory and antioxidant effects. Its pharmacokinetic and pharmacodynamic profile makes it the mostsuitable for the perioperative setting...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 19/05/2023