Criterios de respuesta para definir éxito en la terapia de pacientes hemofílicos llevados a cirugía: Revisión ampliada de la literatura (RAL)
Response criteria to define success in the therapy of hemophilic patients undergoing surgery: Extended literature review (RAL)
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La hemofilia, enfermedad congénita de baja prevalencia en la población general, se clasifica en tipos A y B según su deficiencia sea del factor VIII o IX de la coagulación. Desde hace más de 40 años existen preparados plasmáticos de cada uno de los factores y en la actualidad contamos con derivados recombinantes. Los pacientes que requieren intervenciones quirúrgicas son un reto para los diferentes grupos de manejo, porque el estándar de criterios para definir la respuesta a la terapia no está claro. Se realizó esta revisión ampliada de la literatura con el fin de evaluar cuáles son los criterios de respuesta en las diferentes publicaciones. En las principales bases de datos médicos, se recolectaron y tabularon 61 artículos después de aplicar los criterios de inclusión y exclusión, encontrando que múltiples estudios aplicaban diferentes parámetros para evaluar el sangrado como son los niveles de factor de la coagulación, tromboelastografía, tiempo de generación de trombina, reintervención quirúrgica, duración de la hospitalización y evaluación de dolor, con lo cual concluimos que hay heterogeneidad en los parámetros que aplican los autores en relación con los objetivos principal y secundarios de nuestra revisión.
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