{"id":26400,"date":"2024-10-23T16:32:06","date_gmt":"2024-10-23T14:32:06","guid":{"rendered":"https:\/\/idibell.cat\/?p=26400"},"modified":"2024-10-23T16:32:06","modified_gmt":"2024-10-23T14:32:06","slug":"un-estudi-publicat-a-jama-mostra-els-bons-resultats-duna-nova-membrana-de-purificacio-sanguinia-extracorporia","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2024\/10\/un-estudi-publicat-a-jama-mostra-els-bons-resultats-duna-nova-membrana-de-purificacio-sanguinia-extracorporia\/","title":{"rendered":"Un estudi publicat a JAMA mostra els bons resultats d\u2019una nova membrana de purificaci\u00f3 sangu\u00ednia extracorp\u00f2ria"},"content":{"rendered":"

La revista <\/span>Journal of the American Medical Association<\/span><\/i> (<\/span>JAMA<\/span><\/i>), publica al seu darrer n\u00famero un estudi liderat per investigadors de l\u2019IDIBELL i l\u2019Hospital Universitari de Bellvitge on es demostra que l\u2019\u00fas d\u2019una nova membrana de purificaci\u00f3 sangu\u00ednia extracorp\u00f2ria redueix de manera important la insufici\u00e8ncia renal aguda despr\u00e9s d\u2019una cirurgia card\u00edaca d\u2019alta complexitat. L\u2019estudi SIRAKI02 ha estat encap\u00e7alat pel grup de recerca en immunitat innata i patologia del malalt cr\u00edtic de l\u2019IDIBELL i l\u2019Hospital de Bellvitge i hi han participat cirurgians card\u00edacs, anestesi\u00f2legs, bioqu\u00edmics i perfusionistes del mateix hospital. A m\u00e9s, hi han fet tamb\u00e9 una aportaci\u00f3 fonamental especialistes de l\u2019Hospital Universitari Germans Trias i Pujol i de l\u2019Hospital de la Santa Creu i Sant Pau.<\/span>\u00a0<\/span><\/p>\n

Simult\u00e0niament a la seva publicaci\u00f3 a <\/span>JAMA<\/span><\/i>, l\u2019estudi ha estat presentat pel seu primer autor, el Dr. Xos\u00e9 Luis P\u00e9rez Fern\u00e1ndez, al Congr\u00e9s de la Societat Europea de Medicina Intensiva (ESICM), que es va celebrar del 7 al 9 d\u2019octubre a Barcelona. El mar\u00e7 de 2023, els resultats preliminars ja es van presentar al 42nd International Symposium on Intensive Care & Emergency Medicine, celebrat a Brussel\u00b7les.<\/span>\u00a0<\/span><\/p>\n

La insufici\u00e8ncia renal aguda \u00e9s una p\u00e8rdua sobtada de la capacitat dels ronyons d\u2019eliminar les restes perjudicials que transporta la sang. Es tracta d\u2019un problema secundari important entre les persones ingressades en estat cr\u00edtic a l\u2019hospital, i tamb\u00e9 una conseq\u00fc\u00e8ncia freq\u00fcent d\u2019haver-se sotm\u00e8s a una cirurgia card\u00edaca, especialment si \u00e9s d\u2019alta complexitat. Amb aquest estudi, els investigadors han volgut analitzar si aquests casos d\u2019insufici\u00e8ncia renal despr\u00e9s d\u2019una operaci\u00f3 card\u00edaca complexa disminueixen en cas que, durant la cirurgia, es connecti a la circulaci\u00f3 extracorp\u00f2ria una membrana d\u2019adsorci\u00f3 augmentada. Aquest tipus de membrana d\u2019\u00faltima generaci\u00f3 es va comen\u00e7ar a utilitzar fa uns anys per a les ter\u00e0pies de substituci\u00f3 renal cont\u00ednua a les UCI i per al maneig de la s\u00e8psia, per\u00f2 aquesta ha estat la primera vegada, despr\u00e9s de diferents estudis, en qu\u00e8 el seu \u00fas s\u2019ha aconseguit associar a beneficis cl\u00ednics.<\/span>\u00a0<\/span><\/p>\n

L\u2019assaig va incloure 343 pacients dels hospitals de Bellvitge i Germans Trias i Pujol sotmesos entre el 2016 i el 2022 a cirurgies que requerien circulaci\u00f3 extracorp\u00f2ria durant m\u00e9s de 90 minuts (principalment cirurgies de doble substituci\u00f3 de v\u00e0lvula card\u00edaca, o de substituci\u00f3 de v\u00e0lvula card\u00edaca i <\/span>bypass<\/span><\/i> d\u2019art\u00e8ria coron\u00e0ria). Des del Laboratori de Bioqu\u00edmica de l\u2019Hospital de Sant Pau, es va avaluar la resposta inflamat\u00f2ria dels pacients quantificant els mesuradors inflamatoris obtinguts durant i despr\u00e9s de la cirurgia. El resultat va ser que, en els pacients del grup de control (169 persones) hi va haver un 40% de casos d\u2019insufici\u00e8ncia renal aguda durant la setmana posterior a la intervenci\u00f3, mentre que, en els pacients en qu\u00e8 es va utilitzar la nova membrana (174 persones), aquesta proporci\u00f3 es va reduir al 28%. A m\u00e9s, es va poder comprovar que el dispositiu no provoca problemes afegits als pacients i que els infermers perfusionistes \u2013experts en aparells de circulaci\u00f3 extracorp\u00f2ria\u2013 el van poder fer funcionar de forma senzilla.<\/span>\u00a0<\/span><\/p>\n

Si es confirmen aquests resultats, es podria establir l\u2019\u00fas rutinari d\u2019aquests dispositius en els pacients de risc que se sotmetin a cirurgia card\u00edaca amb circulaci\u00f3 extracorp\u00f2ria. Tamb\u00e9 \u00e9s probable que aquest dispositiu tingui altres beneficis cl\u00ednics per al pacient i escurci la seva estada a l\u2019UCI, si b\u00e9 caldr\u00e0 un estudi amb un nombre m\u00e9s alt de pacients per confirmar-ho.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

L\u2019Institut d’Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l’Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l’Institut Catal\u00e0 de la Salut, l’Institut Catal\u00e0 d’Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/span><\/i>\u00a0<\/span><\/p>\n

L\u2019IDIBELL \u00e9s membre del Campus d’Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L’any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/span><\/i>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Els resultats de l\u2019estudi SIRAKI02 demostren que l\u2019\u00fas d\u2019una nova membrana de purificaci\u00f3 sangu\u00ednia extracorp\u00f2ria redueix la insufici\u00e8ncia renal aguda despr\u00e9s de la cirurgia card\u00edaca complexa. A m\u00e9s, s\u2019ha comprovat que aquest dispositiu no provoca cap problema afegit al pacient i que \u00e9s de f\u00e0cil utilitat pels infermers perfusionistes.<\/p>\n","protected":false},"author":8,"featured_media":26401,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[374,334,466],"tags":[],"class_list":["post-26400","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-immunitat-innata-i-patologia-del-malalt-critic","category-medicina-translacional","category-p-de-malalties-cardiovasculars-respiratories-sistemiques-i-denvelliment-cellular"],"publishpress_future_action":{"enabled":false,"date":"2024-11-04 08:08:58","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/26400"}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=26400"}],"version-history":[{"count":1,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/26400\/revisions"}],"predecessor-version":[{"id":26402,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/26400\/revisions\/26402"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/26401"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=26400"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=26400"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=26400"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}