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• W1985684041 abstract "Los inhibidores del enzima de la angiotensina (IECA) son un conjunto de fármacos con crucial importancia en el control de la hipertensión arterial (HTA), y es por ello que cada vez acuden al quirófano más pacientes bajo este tratamiento. Por otra parte, se percibe un aumento en la incidencia de hipotensión arterial severa, principalmente en pacientes hipovolémicos, ancianos y tomadores de IECA, sobre todo durante la inducción anestésica. Si tenemos en cuenta que la tensión arterial (TA) se mantiene por tres sistemas principales como son: sistema nervioso simpático, sistema renina-angiostensina-aldosterona (SRAA) y vasopresina, y que tanto la anestesia general como la epidural bloquean el sistema nervioso simpático, los pacientes con el SRAA inhibido sólo dispondrán de la vasopresina para el mantenimiento de la TA. Esto explica brevemente el mecanismo por el que durante la anestesia se dan frecuentemente episodios de hipotensión arterial severa y refractaria el tratamiento con fluidos en primera instancia y vasopresores después en pacientes en tratamiento crónico con IECA. Angiotensin converting enzyme inhibitors (AECI) are a set of drugs of crucial importance hipertension control, and that is the reason why more and more patients attend to operating room beneath this treatment. On the other hand, several cases of hypotension have been reported in patients receiving ACEIs as long term therapy, mainly in hypovolemic patients, elders, and during the induction of anesthesia. If we take into account that the blood pressure is maintain by three main systems such as sympathetic nervous systems, renine-angiotensine-aldosterone system (RAAS) and vasopresine, and that both, general and epidural anesthesia blocked the sympathetic nervous system, patients with the RAAS inhibited will only have vasopresine for their blood presure manteinance. All above explains briefly the mechanism by which, during anesthesia, there are often episodes of severe hypotension and refractary to the usual treatment, firstly with fluids and with vasopressors later, in patients receiving ACEIs as a long term therapy. Angiotentsinaren entzimaren inhibitzaileak (IECA) hipertentsio arteriala (HTA) kontrolatzeko berebiziko garrantzia duten botika multzoa dira. Hala, geroz eta gehiago dira operazio-gelara tratamendu horren pean hurbiltzen diren pazienteak. Bestetik, geroz eta arteria-hipotentsio larri kasu gehiago detektatzen dira, paziente hipobolemiko, adindun eta IECA hartzaileen artean batik bat, indukzio anestesikoan zehar batez ere. Kontuan harturik, batetik, tentsio arteriala hiru sistema nagusik mantentzen dutela: nerbio-sistema sinpatikoak, errenina-angiotentsina-aldosterona sistemak (SRAA) eta basopresinak, eta bestetik, bai anestesia orokorrak, bai epiduralak, nerbio-sistema sinpatikoa blokeatzen dutela, SRAA sistema inhibitua duten pazienteek basopresina besterik ez dute tentsio arterialari eusteko." @default.
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• W1985684041 date "2003-01-01" @default.
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• W1985684041 title "Inhibidores del enzima conversor de angiotensina: controversias" @default.
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• W1985684041 doi "https://doi.org/10.1016/s0304-4858(03)74421-7" @default.
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