Cetoacidosis diabética: actualización del manejo protocolizado en el servicio de emergencias
Diabetic ketoacidosis: an update on the standardized management protocol in the emergency department
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https://doi.org/10.56712/latam.v7i2.5744Palabras clave:
cetogénesis, anión gap, diuresis osmóti, hipokalemia, insulinoterapiaResumen
La cetoacidosis diabética es una emergencia metabólica aguda frecuente en el servicio de urgencias que se asocia con morbilidad significativa y requiere diagnóstico y tratamiento oportunos. El objetivo de este trabajo fue sintetizar la fisiopatología, los factores precipitantes, las manifestaciones clínicas, el abordaje diagnóstico y el manejo actual de la cetoacidosis diabética en el contexto de la atención de emergencias. Se realizó una revisión narrativa de la literatura enfocada en estudios y documentos clínicos sobre fisiopatología, diagnóstico, tratamiento y prevención de complicaciones. La evidencia revisada mostró que la deficiencia absoluta o relativa de insulina, junto con el aumento de hormonas contrarreguladoras, favorece la gluconeogénesis, la glucogenólisis y la lipólisis, lo que genera hiperglucemia, cetonemia y acidosis metabólica con aumento del anión gap. También mostró que la diuresis osmótica produce deshidratación y alteraciones electrolíticas, en especial del potasio, y que entre los principales factores precipitantes se encuentran las infecciones, la omisión de insulina, las enfermedades agudas, algunos fármacos y el debut diabético. Las manifestaciones más frecuentes incluyen poliuria, polidipsia, náuseas, vómitos, dolor abdominal, deshidratación, respiración de Kussmaul y alteración del estado de conciencia. Se concluyó que el manejo protocolizado basado en reposición de líquidos, insulina intravenosa, corrección electrolítica y monitorización continua permite resolver el cuadro, mientras que la educación del paciente y el monitoreo de glucosa ayudan a reducir recurrencias y complicaciones.
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Derechos de autor 2026 Stephany González Lobo, Yarizol Delgado Paniagua, Lloyd Steven Shedden Hidalgo, Joshmar Tadlaoui Gonzalez
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
