Estrategias farmacoterapéuticas emergentes en cuidados críticos: revisión narrativa
Palabras clave:
cuidados críticos, gestión de ciencia, tecnología e innovación en salud, quimioterapia
Resumen
La unidad de cuidados intensivos (UCI) se caracteriza por una elevada complejidad clínica, la necesidad de intervenciones inmediatas y una monitorización continua, cada vez más impulsadas por terapias innovadoras. Esta revisión sintetiza la literatura actual sobre las principales innovaciones y terapias emergentes con potencial para transformar el manejo farmacológico del paciente críticamente enfermo. Se realizó una búsqueda bibliográfica hasta marzo de 2026 en Medline (PubMed) y la Biblioteca Virtual en Salud (BVS), mediante palabras clave o combinaciones en inglés y/o portugués: “critical care”, “innovation” y “drug therapy”. Entre las principales innovaciones se incluyen la monitorización terapéutica de fármacos integrada con el modelado farmacocinético/farmacodinámico (PK/PD), los biomarcadores para la estratificación del riesgo y las terapias inmunomoduladoras, celulares y dirigidas a dianas moleculares. En la sepsis y el síndrome de distrés respiratorio agudo (SDRA), la investigación avanza hacia subfenotipos definidos biológicamente; en el neurointensivismo, la sedoanalgesia neuroprotectora y los sistemas de liberación dirigida de fármacos adquieren creciente protagonismo; y en la lesión renal aguda (LRA), las estrategias emergentes se centran en dianas inflamatorias y metabólicas, así como en enfoques multiómicos. La farmacogenómica y la inteligencia artificial (IA) sustentan la medicina crítica de precisión. La superación de las barreras operativas permitirá que estas tecnologías optimicen la farmacoterapia, reduzcan los acontecimientos adversos y respalden la toma de decisiones clínicas en tiempo real, siempre que se sustenten en guías basadas en la evidencia, una gobernanza institucional sólida y una formación multidisciplinar continua. En definitiva, unos cuidados intensivos personalizados —guiados por biomarcadores, datos digitales e IA, y sin dejar de ser centrados en el paciente, seguros, eficaces y sostenibles— requieren un abordaje multidisciplinar coordinado que permita trasladar los avances científicos a beneficios clínicos tangibles.
Citas
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