Análisis y procedimientos de Enfermería ante pacientes con neurotoxicidades derivadas de la Inmunoterapia con Células T modificadas por Receptores de Antígenos Quiméricos (CAR): Una revisión sistemática
DOI:
https://doi.org/10.33448/rsd-v14i9.49533Palabras clave:
Enfermería, Atención de Enfermería, Terapia de Receptores de Antígenos Quiméricos, Terapia con Células T CAR, Síndromes de Neurotoxicidad.Resumen
La inmunoterapia CAR-T representa una revolución innovadora en el tratamiento de neoplasias hematológicas, aunque su éxito se ve contrarrestado por un perfil de neurotoxicidad único y potencialmente fatal, destacando el Síndrome de Liberación de Citoquinas (CRS) y el Síndrome de Neurotoxicidad Asociado a Células Efectoras Inmunes (ICANS). El objetivo fue sintetizar y analizar sistemáticamente la evidencia científica sobre los procedimientos e intervenciones de enfermería para el monitoreo, evaluación y manejo de los efectos adversos en pacientes que presentan neurotoxicidades asociadas a la inmunoterapia CAR-T. Se realizó una revisión sistemática siguiendo las directrices de PRISMA2020, con una síntesis narrativa orientada por la directriz SWiM (Synthesis Without Meta-Analysis) y se aplicó el Análisis de Contenido de Bardin. Las búsquedas se realizaron en las bases de datos PubMed, Web of Science, Scopus, Embase y BVS. Tras aplicar los criterios de inclusión y exclusión, se utilizaron 44 documentos en la presente revisión. La investigación demuestra que la enfermería especializada es fundamental en la seguridad del paciente, actuando en la detección precoz de las neurotoxicidades a través de una monitorización rigurosa y la aplicación de herramientas estandarizadas, como la puntuación ICE para la evaluación neurológica. Las intervenciones de enfermería abarcan desde cuidados de soporte hasta la administración de terapias de rescate, como Tocilizumab y Corticosteroides, y la intensificación del cuidado a la UCI. Además de la fase aguda, el papel de la enfermería es vital en la gestión de complicaciones tardías, como la Hipogammaglobulinemia y la Aplasia de Células B, coordinando planes de supervivencia y la educación del paciente. La conclusión refuerza que la Enfermería de Práctica Avanzada es un componente indispensable para mitigar la morbimortalidad, con el fin de garantizar el éxito de la inmunoterapia CAR-T.
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Derechos de autor 2025 Leandro Maia Leão, Moisés Davi da Silva Bomfim, Uirassú Tupinambá Silva de Lima, Ednólia Nobre Lopes de Lima, Ellen Aline Moya Nicolau Pieper, Ticiane Rosa de Carvalho Costa, Kleytonn Giann Silva de Santana, Dallyne Rebeca Santos Tojal, Sofia Vieira da Costa, Lucas dos Santos Santana, Luciana da Silva Viana
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3) Los autores tienen permiso y son estimulados a publicar y distribuir su trabajo en línea (por ejemplo, en repositorios institucionales o en su página personal) a cualquier punto antes o durante el proceso editorial, ya que esto puede generar cambios productivos, así como aumentar el impacto y la cita del trabajo publicado.
