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El síndrome de BRASH surge de un fenómeno sinergista desencadenante de un ciclo vicioso que involucra la interacción entre bradicardia, falla renal, fármacos bloqueadores de la conducción atrioventricular, choque e hiperkalemia. Debido a que es una patología de reciente análisis, su identificación usualmente pasa desapercibida interpretándose como otra afección, lo que da pie a implementar modelos terapéuticos no fundamentados en la fisiopatología subyacente, resultando en el aumento de la morbimortalidad del paciente. El abordaje terapéutico involucra terapia de soporte básico para el manejo de la hiperkalemia, bradicardia y resucitación con fluidoterapia. Usualmente, las medidas básicas son suficientes para romper el ciclo vicioso. Proporcionar una discusión del modelo fisiopatológico mejora el entendimiento y el reconocimiento de esta patología, optimizando el pronóstico de los pacientes que la padezcan.
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Farkas JD, Long B, Koyfman A, Menson K. BRASH Syndrome: Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalemia. J Emerg Med. 2020 Aug;59(2):216–23.
Schnaubelt S, Roeggla M, Spiel AO, Schukro C, Domanovits H. The BRASH syndrome: an interaction of bradycardia, renal failure, AV block, shock and hyperkalemia. Intern Emerg Med. 2021 Mar;16(2):509–11.
Halli-Tierney A, Scarbrough C, Carroll DG. Polypharmacy: Evaluating Risks and Deprescribing. Am Fam Physician. 2019 Jul 1;100(1):32–8.
Ravioli S, Woitok BK, Lindner G. BRASH syndrome – fact or fiction? A first analysis of the prevalence and relevance of a newly described syndrome. Eur J Emerg Med. 2021 Apr;28(2):153–5.
Lizyness K, Dewald O. BRASH Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 Oct 5]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK570643/
Sarkar S, Rapista N, Rout A, Chaudhary R. BRASH: Case Report and Review of Literature. Hearts. 2021 Jun 27;2(3):302–6.
Srivastava S, Kemnic T, Hildebrandt KR. BRASH syndrome. BMJ Case Rep. 2020 Feb;13(2):e233825.
Prabhu V, Hsu E, Lestin S, Soltanianzadeh Y, Hadi S. Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome as a Presentation of Coronavirus Disease 2019. Cureus [Internet]. 2020 Apr 24 [cited 2021 Oct 6]; Available from: https://www.cureus.com/articles/31127-bradycardia-renal-failure-atrioventricular-nodal-blockade-shock-and-hyperkalemia-brash-syndrome-as-a-presentation-of-coronavirus-disease-2019
Grigorov MV, Belur AD, Otero D, Chaudhary S, Grigorov E, Ghafghazi S. The BRASH syndrome, a synergistic arrhythmia phenomenon. Bayl Univ Med Cent Proc. 2020 Oct 1;33(4):668–70.
Wong C, Jaafar M. Bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia: An important syndrome to recognize. Turk J Emerg Med. 2021;21(2):86.
Nagamine T. BRASH syndrome associated with angiotensin receptor blocker and SGLT2 inhibitor. Can J Emerg Med [Internet]. 2021 Oct 1 [cited 2021 Oct 6]; Available from: https://link.springer.com/10.1007/s43678-021-00213-9
Ata F, yasir M, Javed S, Bilal ABI, Muthanna B, Minhas B, et al. Diagnostic and therapeutic challenges of BRASH syndrome: A case report. Med Case Rep Study Protoc. 2021 Jan;2(1):e0018.
Diribe N, Le J. Trimethoprim/Sulfamethoxazole-Induced Bradycardia, Renal Failure, AV-Node Blockers, Shock and Hyperkalemia Syndrome. Clin Pract Cases Emerg Med. 2019 Jul 22;3(3):282–5.
Flores S. Anaphylaxis induced bradycardia, renal failure, AV-nodal blockade, shock, and hyperkalemia: A-BRASH in the emergency department. Am J Emerg Med. 2020 Sep;38(9):1987.e1-1987.e3.
Sattar Y, Bareeqa SB, Rauf H, Ullah W, Alraies MC. Bradycardia, Renal Failure, Atrioventricular-nodal Blocker, Shock, and Hyperkalemia Syndrome Diagnosis and Literature Review. Cureus [Internet]. 2020 Feb 13 [cited 2021 Oct 6]; Available from: https://www.cureus.com/articles/27877-bradycardia-renal-failure-atrioventricular-nodal-blocker-shock-and-hyperkalemia-syndrome-diagnosis-and-literature-review
Arif AW, Khan MS, Masri A, Mba B, Ayub MT, Doukky R. BRASH Syndrome with Hyperkalemia: An Under-Recognized Clinical Condition. Methodist DeBakey Cardiovasc J. 2020 Jul 1;16(3):241.
Vishnu V, Jamshed N, Amrithanand V, Thandar S. BRASH Syndrome: A Case Report. J Emerg Med. 2021 Jun;60(6):818–22.
Park JI, Jung MS, Lee H, Kim H, Oh J. Implication of AV node blockers in patients with end-stage renal disease undergoing head and neck surgery; BRASH syndrome: a case report. Braz J Anesthesiol Engl Ed. 2021 May;S0104001421001998.
Barreras N. Brash Syndrome, Can You See the Cycle? In: C44 CRITICAL CARE CASE REPORTS: METABOLIC, RENAL, AND ENDOCRINE [Internet]. American Thoracic Society; 2020 [cited 2021 Oct 4]. p. A5184–A5184. Available from: https://www.atsjournals.org/doi/10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A5184
Savage P, McEneaney D. BRASH SYNDROME: AN UNDER RECOGNISED CAUSE OF COMPLETE HEART BLOCK IN THE ELDERLY. Ulster Med J. 2020 Sep;89(2):123–4.
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