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Pulsos o megadosis de esteroides: ¿cuándo están indicados?
Resumen
Cada vez es más frecuente el ingreso de pacientes a las unidades de cuidado intensivo con enfermedades reumatológicas y autoinmunes descompensadas y con
compromiso vital inminente. Además de soportar los fallos orgánicos que amenazan la vida de éstos pacientes, se debe procurar controlar y frenar la
catástrofe orgánica establecida, para ello los esteroides son fàrmacos de primera línea, solos o en conjunto con otros medicamentos inmonomoduladores/inmunosupresores. Sin embargo, ¿cuándo recurrir a los esteroides a dosis convencionales por vía oral/intravenosa o cuándo administrar
pulsos (megadosis)?. En ésta revisión trataremos de contestar ésta pregunta con la mejor evidencia disponible y entregar una herramienta que permita la toma
de decisiones a los médicos que atienden a éstos pacientes.
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