Atualizações em Suporte Hemodinâmico e Estratégias Terapêuticas no Choque Séptico
DOI:
https://doi.org/10.36557/2674-8169.2025v7n7p1672-1686Palavras-chave:
Choque séptico; Hemodinâmica; Reposição volêmica.Resumo
O choque séptico representa uma condição crítica com alta mortalidade e morbidade, sendo um estágio avançado da sepse associado à disfunção circulatória e hipoperfusão tecidual. Esta revisão narrativa analisa as principais estratégias de suporte hemodinâmico baseadas em evidências atuais, com foco na reanimação volêmica, uso de vasopressores e indicadores dinâmicos de perfusão. Foram incluídos 30 estudos selecionados nas bases SciELO, PubMed, BVS e Microsoft Academic Search, publicados entre 2021 e 2024. A terapia guiada por metas precoces, embora amplamente adotada, tem sido questionada por recentes ensaios clínicos quanto à sua efetividade. A reanimação deve priorizar o uso de cristaloides, noradrenalina como vasopressor de escolha e monitoramento de parâmetros como lactato, SvO₂ e variação da pressão de pulso. Métodos dinâmicos como ultrassom da veia cava e teste de elevação passiva das pernas auxiliam na avaliação da responsividade volêmica. Conclui-se que o manejo individualizado e precoce, guiado por parâmetros clínicos e laboratoriais, é fundamental para melhorar os desfechos em pacientes com choque séptico.
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Copyright (c) 2025 Marina Silva Camarço Lima , Francisco Javier Gonzalez Benítez , José Antonio Moreira Parra , Lucas Pedro Fernandes, Fernando Bernardino Hashimoto, Letícia Caparroz, Felipe de Azevedo Soares Alvarenga, Victoria Gabriele Marcitelli dos Santos , Ian de Almeida Pernambuco Sachs , Gabriela Bittencourt Duarte Villela, Charllyes Rodrigues , Filippi Valentino Agostinho Villarta , Rúbia Laureano de Toledo, Marcelo Fernandes Roma
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os autores são detentores dos direitos autorais mediante uma licença CCBY 4.0.
