Estrategia diagnóstica y terapéutica dirigida a pacientes con VIH en unidades de cuidados intensivos: Revisión narrativa
Palabras clave:
VIH, Virus de la inmunodeficiencia humana, Unidad de cuidados intensivos, Cuidados críticos, Enfermedad crítica, PrognosisResumen
Desde la aparición de la terapia antirretroviral efectiva, en los últimos 20 años, la infección por el virus de inmunodeficiencia humana (VIH) se ha convertido en una enfermedad infecciosa crónica. En este contexto, el objetivo de esta revisión narrativa fue presentar un enfoque diagnostico organizado y una terapia ajustada a la condición del paciente en unidades de cuidados intensivos. Se realizó una revisión del tema mediante una búsqueda bibliográfica en bases de datos empleando los términos MeSH “intensive care”, “HIV”, “critical illness”, “human immunodeficiency virus”. Se emplearon filtros para seleccionar los artículos en idioma inglés y español. La búsqueda en diferentes bases de datos arrojó un total de 3243 resultados, y tras descartar duplicados y seleccionar por título y resumen, se obtuvieron 151 artículos. Finalmente, 46 artículos se incluyeron en esta revisión de tema, seleccionados después de revisar el texto completo. La terapia antirretroviral oportuna está demostrada que disminuye la morbilidad y mortalidad. Además, es necesario estar alerta frente a la aparición de síndrome inflamatorio de reconstitución inmune, diagnosticarlo y tratarlo. Desde su ingreso a urgencias, los pacientes deben ser evaluados completa, rigurosa y regularmente para identificar cambios clínicos, complicaciones o factores pronósticos. Mediante el inicio oportuno de una estrategia diagnóstica y terapéutica y el traslado a una unidad de cuidados intermedios o intensivos para una monitorización, los pacientes con VIH pueden obtener un manejo adecuado de la condición crítica y mejorar su pronóstico.
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