O uso de Milrinona na Hemorragia Subaracnóidea Espontânea / The Use of Milrinone in Spontaneous Subarachnoid Hemorrhage

Authors

  • Maria Clara Potiguara Azevedo Teixeira
  • Beatriz Toledo Mendes
  • Clara Demeneck Pereira
  • Matheus Macêdo da Silva
  • Pedro Victor Matos Moreno da Silva
  • Henrique de Lacerda Pereira

DOI:

https://doi.org/10.34119/bjhrv4n6-127

Keywords:

Hemorragia subaracnóidea, Vasoespasmo cerebral, Milrinona.

Abstract

O termo “hemorragia subaracnóidea” (HSA) se refere ao sangramento que ocorre entre a aracnoide e a pia-máter, meninges encefálicas. É consagrada como importante causa de morte prematura e incapacidade, sendo que a principal causa de morbimortalidade nesses pacientes é o vasoespasmo cerebral relacionado à isquemia tardia, que é decorrente do estreitamento das artérias do cérebro após um episódio de HSA. A patogênese desse fenômeno permanece pouco compreendida, e os mecanismos potenciais incluem a contração do músculo liso e a inflamação, que podem levar ao remodelamento dos vasos e também a uma hipoperfusão cerebral aguda. A literatura sobre a abordagem terapêutica do vasoespasmo pós HSA é limitada, apesar do aumento significativo da ocorrência da mesma nas últimas décadas. Uma possível intervenção é o uso da Milrinona, que é um conhecido inibidor seletivo da fosfodiesterase 3 e age como vasodilatador, aumentando o débito cardíaco e o fluxo sanguíneo cerebral. Nessa perspectiva, esse artigo tem o intuito de discutir se o uso desse medicamento em pacientes com HSA é benéfico, analisando sua influência sobre a morbimortalidade, além de avaliar a melhor via de administração nesses casos. Para tal, foi realizada uma revisão de literatura acerca de seu uso em pacientes com vasoespasmo cerebral e suas repercussões. Dos 7 artigos analisados, 6 foram favoráveis à utilização da droga, enquanto 1 foi desfavorável. Portanto, embora múltiplos estudos científicos e relatos de caso embasem a utilização da mesma para tratar a condição, ainda restam alguns relatos contrários, reforçando a necessidade de mais estudos, principalmente um controlado randomizado para validar seu uso na HSA.

 

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Published

2021-11-17

How to Cite

TEIXEIRA, M. C. P. A.; MENDES, B. T.; PEREIRA, C. D.; DA SILVA, M. M.; DA SILVA, P. V. M. M.; PEREIRA, H. de L. O uso de Milrinona na Hemorragia Subaracnóidea Espontânea / The Use of Milrinone in Spontaneous Subarachnoid Hemorrhage. Brazilian Journal of Health Review, [S. l.], v. 4, n. 6, p. 25189–25198, 2021. DOI: 10.34119/bjhrv4n6-127. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/39658. Acesso em: 29 mar. 2024.

Issue

Section

Original Papers