Prevenção da Sépsis Pós-esplenectomia: criação de um protocolo de vacinação e educação do doente esplenectomizado.
Abstract
A sépsis pós-esplenectomia é uma entidade rara, mas está associada a uma elevada mortalidade, justificando a existência de várias medidas para a sua prevenção, nomeadamente o esquema de vacinação e as estratégias de educação dos doentes. A profilaxia antibiótica permanece não consensual. Para além de serem alvo de discussão e de existirem diferentes guidelines com recomendações diferentes, ainda se acrescenta o grave problema do seu incumprimento ou desconhecimento pela maioria dos médicos, havendo doentes sem qualquer medida preventiva. No panorama nacional, não existem quaisquer protocolos ou normas de orientação clínica sobre esta entidade, excepto uma referência breve no plano nacional de vacinação. Vimos propor um protocolo de vacinação e de educação para estes doentes.
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References
1. Di Sabatino A, Carsetti R, Corazza GR: Post-Splenectomy And Hyposplenic States. Lancet 2011; 378: 86-97
2. Okabayashi T, Hanazaki K: Overwhelming postsplenectomy infection syndrome in adults – A clinically preventable disease. World J Gastroenterol 2008; 14 (2): 176-9
3. Barron J, O’neal, John C, Mcdonald: The risk of Sepsis in the asplenic adult. Ann. Surg. 1981; 194(6): 775-8
4. Spealman D, Buttery A, Daley D et al: Guidelines for the prevention of sepsis in asplenic and hyposplenic patients. Internal Medicine Journal 2008; 38: 349-56
5. Kotsanas D, Al-Souffi MH, Waxman BB, King RWF, Polkinghorne KR, Woolley IJ: Adherence to guidelines for preventionof postsplenectomy sepsis. Age and sex are risk factors: a five-year retrospective review. Journal of surgery. 2006; 76: 542-7
6. Hegarty PK, Tan B, O’sullivan R, Cronin CC, Brady MP: Prevention os postslenectomy sepsis: how much do patients know? Hematol J. 2000; 1(5): 357-9
7. Melles DC, Marie S: Prevention of infections in hyposplenic and asplenic patients: an update. The Netherlands Journal of Medicine. 2004; 62(2)
8. Rufer A, Wuillemin WA: The spleen in non-mallignat haematological disorders. Ther Umsch. 2013; 70 (3): 157-62
9. Benoit S: Median and long-term complications of splenectomy. Ann Chir. 2000; 125(4): 317-24
10. Newland A: Preventing severe infection after splenectomy (Editorial). Br Med J. 2005; 331: 417-8
11. Menezes, MP: “Autotransplante do baço” (Tese de Mestrado). Repositório de Teses da Universidade da Beira Interior. 2009
12. Shatz DV: Vaccination practices among North American trauma surgeons in splenectomy for trauma. J Trauma. 2002; 53 (5): 950-6
13. Centers for Disease Control and Prevention: General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). 2011
14. Pastemack M: Prevention of sepsis in the asplenic patient. UpToDate. 2012
15. Direcção Geral da Saúde - Divisão das Doenças transmissíveis: Plano Nacional de Vacinação. 2006
16. Davidson RN, Wall RA: Prevention and management of infections in patients without a spleen. Clin Microbial Infect. 2001; 7: 757-60
17. Shatz DV, Schinsky MF, Pais LB, Romero-Steiner S, Kirton OC, Carlone GM: Immune responses of splenectomized trauma patients to the 23-valent pneumococcal polysaccharide vaccine at 1 versus 7 versus 14 days after splenectomy. J Trauma. 1998; 44(5): 760-6
18. Schreiber MA, Pusateri AE, Veit BC, Smiley RA, Morrison CA, Harris RA: Timing of vaccination does not affect antibody response or survival after pneumococcal challenge in splenectomized rats. J Trauma. 1998; 45(4): 692-9
19. Shatz DV, Romero-Steiner S, Elie CM, Holder PF, Carlone GM: Antibody responses in postsplenectomy trauma patients receiving the 23-valent pneumococcal polysaccharide vaccine at 14 versus 28 days postoperatively. J Trauma. 2002; 53(6): 1037-42
20. INFARMED – Autoridade Nacional do Medicamento e Produtos de Saúde/ Ministério da Saúde: Prontuário Terapêutico 2013. 2012
21. Dahyot-Fizelier C, Mimoz O: Gestion du patient splénectomisé. Société Française d’Anesthesie et de Réanimation. 2010
22. Jones P, Leder K, Woolley I, Cameron P Cheng A, Spelman D: Postsplenectomy infection – strategies for prevention in general practice. Aust Fam Physician. 2010; 39(6): 383-6
2. Okabayashi T, Hanazaki K: Overwhelming postsplenectomy infection syndrome in adults – A clinically preventable disease. World J Gastroenterol 2008; 14 (2): 176-9
3. Barron J, O’neal, John C, Mcdonald: The risk of Sepsis in the asplenic adult. Ann. Surg. 1981; 194(6): 775-8
4. Spealman D, Buttery A, Daley D et al: Guidelines for the prevention of sepsis in asplenic and hyposplenic patients. Internal Medicine Journal 2008; 38: 349-56
5. Kotsanas D, Al-Souffi MH, Waxman BB, King RWF, Polkinghorne KR, Woolley IJ: Adherence to guidelines for preventionof postsplenectomy sepsis. Age and sex are risk factors: a five-year retrospective review. Journal of surgery. 2006; 76: 542-7
6. Hegarty PK, Tan B, O’sullivan R, Cronin CC, Brady MP: Prevention os postslenectomy sepsis: how much do patients know? Hematol J. 2000; 1(5): 357-9
7. Melles DC, Marie S: Prevention of infections in hyposplenic and asplenic patients: an update. The Netherlands Journal of Medicine. 2004; 62(2)
8. Rufer A, Wuillemin WA: The spleen in non-mallignat haematological disorders. Ther Umsch. 2013; 70 (3): 157-62
9. Benoit S: Median and long-term complications of splenectomy. Ann Chir. 2000; 125(4): 317-24
10. Newland A: Preventing severe infection after splenectomy (Editorial). Br Med J. 2005; 331: 417-8
11. Menezes, MP: “Autotransplante do baço” (Tese de Mestrado). Repositório de Teses da Universidade da Beira Interior. 2009
12. Shatz DV: Vaccination practices among North American trauma surgeons in splenectomy for trauma. J Trauma. 2002; 53 (5): 950-6
13. Centers for Disease Control and Prevention: General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). 2011
14. Pastemack M: Prevention of sepsis in the asplenic patient. UpToDate. 2012
15. Direcção Geral da Saúde - Divisão das Doenças transmissíveis: Plano Nacional de Vacinação. 2006
16. Davidson RN, Wall RA: Prevention and management of infections in patients without a spleen. Clin Microbial Infect. 2001; 7: 757-60
17. Shatz DV, Schinsky MF, Pais LB, Romero-Steiner S, Kirton OC, Carlone GM: Immune responses of splenectomized trauma patients to the 23-valent pneumococcal polysaccharide vaccine at 1 versus 7 versus 14 days after splenectomy. J Trauma. 1998; 44(5): 760-6
18. Schreiber MA, Pusateri AE, Veit BC, Smiley RA, Morrison CA, Harris RA: Timing of vaccination does not affect antibody response or survival after pneumococcal challenge in splenectomized rats. J Trauma. 1998; 45(4): 692-9
19. Shatz DV, Romero-Steiner S, Elie CM, Holder PF, Carlone GM: Antibody responses in postsplenectomy trauma patients receiving the 23-valent pneumococcal polysaccharide vaccine at 14 versus 28 days postoperatively. J Trauma. 2002; 53(6): 1037-42
20. INFARMED – Autoridade Nacional do Medicamento e Produtos de Saúde/ Ministério da Saúde: Prontuário Terapêutico 2013. 2012
21. Dahyot-Fizelier C, Mimoz O: Gestion du patient splénectomisé. Société Française d’Anesthesie et de Réanimation. 2010
22. Jones P, Leder K, Woolley I, Cameron P Cheng A, Spelman D: Postsplenectomy infection – strategies for prevention in general practice. Aust Fam Physician. 2010; 39(6): 383-6
Published
2014-12-31
How to Cite
DUARTE, Liliana Almeida et al.
Prevenção da Sépsis Pós-esplenectomia: criação de um protocolo de vacinação e educação do doente esplenectomizado..
Revista Portuguesa de Cirurgia, [S.l.], n. 31, p. 9-18, dec. 2014.
ISSN 2183-1165.
Available at: <https://revista.spcir.com/index.php/spcir/article/view/361>. Date accessed: 26 apr. 2024.
Section
Original Papers
