Resumen
La fiebre amarilla (FA) ha sido una enfermedad de relevancia para la salud pública desde su primera des-cripción en el siglo XV, atravesando distintos períodos críticos en la historia de la humanidad. Ha provocado sufrimientos incalculables y una miseria indescriptible en poblaciones de América, Europa y África (1). El manejo de la disfunción orgánica múltiple, en particular la insuficiencia hepática aguda secundaria a FA en Unidades de Cuidado Intensivo (UCI), requiere un abordaje integral, multidisciplinario y agresivo, orientado a estabilizar al paciente, tratar las complicaciones sistémicas y, de ser necesario, preparar el trasplante hepático (2). Este protocolo establece las directrices para el manejo integral de pacientes adultos con FA grave ingresados en la UCI de la Clínica Colsanitas. Incluye criterios clínicos y paraclínicos para el ingreso, contemplando parámetros de disfunción hepática, renal, respiratoria, cardiovascular y neurológica. La estrategia terapéutica abarca la monitorización continua, el soporte hemodinámico personalizado, la ventilación mecánica protectora, la terapia de reemplazo renal, el manejo de coagulopatías guiado por tromboelastografía y el uso de plasmaféresis intensiva en casos seleccionados. Además, se consideran
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