Tormenta tiroidea, una emergencia endocrina. Directrices actualizadas de su manejo
DOI:
https://doi.org/10.31790/inspilip.v7i22.423Palabras clave:
Tirotoxicosis, Crisis tiroidea, Terapia, Antitiroideos [DeCS]Resumen
La tormenta tiroidea es una emergencia endocrino metabólica potencialmente mortal, por lo que, contar con un resumen de la mejor evidencia actualizada sobre su tratamiento, resulta de gran importancia. Con el propósito de describir las directrices actuales de manejo de la TT se realizó esta revisión sistemática flexible, a partir de guías, documentos de consenso y artículos de revisión. Se desarrolló una búsqueda basada en términos Mesh, con la que se seleccionaron 15 publicaciones, desde 2015 hasta la actualidad. La evidencia consultada indica que el manejo de la tormenta tiroidea es multimodal. Implica medidas de soporte: como ingreso en UCI, Identificar y tratar factores precipitantes, oxígeno 5-6L/min, control agresivo de la temperatura, vigilancia del equilibrio hidroelectrolítico y ácido base, hidratación (SSF y Dextrosa 5 % - 10 %), sedación, vitaminoterapia, y protección gástrica. Las medidas específicas incluyen el uso de Propiltiuoracilo (500-1000 mg dosis de carga), después, 250 mg cada 4 horas, Metimazol (60-80 mg/día), Propranolol (60-80 mg cada 4 horas), Iodine (KI) 5 gotas vía oral cada 6 horas e Hicrocortisona (300 mg de carga, después, 100 mg cada 8 horas). Con esta revisión se evidenció que, al ser la tormenta tiroidea es una emergencia potencialmente mortal, amerita una actualización permanente en el abordaje terapéutico, con revisión y divulgación continua de las recomendaciones actuales de tratamiento, como una herramienta de consulta rápida que beneficie a los profesionales médicos y a sus pacientes.
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Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
