Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos
Background:Monitoring of cardiac preload by determination of pulmonary artery occlusion pressure (PAOP) has been traditionally used to guide fluid therapy to optimize cardiac output (CO). Since factors such as intrathoracic pressure and ventricular compliance may modify PAOP, volumetric estimators o...
Guardado en:
| Autores principales: | , , , , , , , , , , |
|---|---|
| Lenguaje: | Spanish / Castilian |
| Publicado: |
Sociedad Médica de Santiago
2005
|
| Materias: | |
| Acceso en línea: | http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000600001 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:scielo:S0034-98872005000600001 |
|---|---|
| record_format |
dspace |
| spelling |
oai:scielo:S0034-988720050006000012005-08-26Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticosTomicic F,VinkoGraf S,JerónimoEchevarría O,GhislaineEspinoza R,MauricioAbarca Z,JuanMontes S,José MiguelTorres M,JavierNúñez U,GastónGuerrero P,JuliaLuppi N,MarioCanals L,Claudio Blood volume Critical illness Pulmonary artery Background:Monitoring of cardiac preload by determination of pulmonary artery occlusion pressure (PAOP) has been traditionally used to guide fluid therapy to optimize cardiac output (CO). Since factors such as intrathoracic pressure and ventricular compliance may modify PAOP, volumetric estimators of preload have been developed. The PiCCO system is able to measure CO and intrathoracic blood volume (ITBV) by transpulmonary thermodilution. Aim: To compare a volumetric (ITBV) versus a pressure (PAOP) determination to accurately estimate cardiac preload in severely ill patients. Patients and Methods: From June 2001 to October 2003, 22 mechanically ventilated patients with hemodynamic instability underwent hemodynamic monitoring with pulmonary artery catheter (PAC) and PiCCO system. ITBV index (ITBVI), PAOP and CI were measured simultaneously by both methods. One hundred thirty eight deltas (D) were obtained from the difference of ITBVI, PAOP, CI-PAC and CI-PiCCO between 6-12 am and 6-12 pm. Linear regression analysis of DITBVI versus Ð CI-PiCCO and Ð PAOP versus DCI-PAC were made. Results: Mean age of patients was 60.8 ± 19.4 years. APACHE II was 23.9 ± 7. Fifteen patients met criteria for acute respiratory distress syndrome (ARDS). Delta ITBVI significantly correlated with DCI-PiCCO (r=0.54; 95% confidence interval = 0.41-0.65; p <0.01). There was no correlation between DPAOP and DCI-PAC. Conclusion: ITBVI correlated better with CI than PAOP, and therefore it seems to be a more accurate estimator of preload in unstable, mechanically ventilated patientsinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.6 20052005-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000600001es10.4067/S0034-98872005000600001 |
| institution |
Scielo Chile |
| collection |
Scielo Chile |
| language |
Spanish / Castilian |
| topic |
Blood volume Critical illness Pulmonary artery |
| spellingShingle |
Blood volume Critical illness Pulmonary artery Tomicic F,Vinko Graf S,Jerónimo Echevarría O,Ghislaine Espinoza R,Mauricio Abarca Z,Juan Montes S,José Miguel Torres M,Javier Núñez U,Gastón Guerrero P,Julia Luppi N,Mario Canals L,Claudio Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos |
| description |
Background:Monitoring of cardiac preload by determination of pulmonary artery occlusion pressure (PAOP) has been traditionally used to guide fluid therapy to optimize cardiac output (CO). Since factors such as intrathoracic pressure and ventricular compliance may modify PAOP, volumetric estimators of preload have been developed. The PiCCO system is able to measure CO and intrathoracic blood volume (ITBV) by transpulmonary thermodilution. Aim: To compare a volumetric (ITBV) versus a pressure (PAOP) determination to accurately estimate cardiac preload in severely ill patients. Patients and Methods: From June 2001 to October 2003, 22 mechanically ventilated patients with hemodynamic instability underwent hemodynamic monitoring with pulmonary artery catheter (PAC) and PiCCO system. ITBV index (ITBVI), PAOP and CI were measured simultaneously by both methods. One hundred thirty eight deltas (D) were obtained from the difference of ITBVI, PAOP, CI-PAC and CI-PiCCO between 6-12 am and 6-12 pm. Linear regression analysis of DITBVI versus Ð CI-PiCCO and Ð PAOP versus DCI-PAC were made. Results: Mean age of patients was 60.8 ± 19.4 years. APACHE II was 23.9 ± 7. Fifteen patients met criteria for acute respiratory distress syndrome (ARDS). Delta ITBVI significantly correlated with DCI-PiCCO (r=0.54; 95% confidence interval = 0.41-0.65; p <0.01). There was no correlation between DPAOP and DCI-PAC. Conclusion: ITBVI correlated better with CI than PAOP, and therefore it seems to be a more accurate estimator of preload in unstable, mechanically ventilated patients |
| author |
Tomicic F,Vinko Graf S,Jerónimo Echevarría O,Ghislaine Espinoza R,Mauricio Abarca Z,Juan Montes S,José Miguel Torres M,Javier Núñez U,Gastón Guerrero P,Julia Luppi N,Mario Canals L,Claudio |
| author_facet |
Tomicic F,Vinko Graf S,Jerónimo Echevarría O,Ghislaine Espinoza R,Mauricio Abarca Z,Juan Montes S,José Miguel Torres M,Javier Núñez U,Gastón Guerrero P,Julia Luppi N,Mario Canals L,Claudio |
| author_sort |
Tomicic F,Vinko |
| title |
Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos |
| title_short |
Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos |
| title_full |
Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos |
| title_fullStr |
Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos |
| title_full_unstemmed |
Volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos |
| title_sort |
volumen sanguíneo intratorácico versus presión arterial de oclusión pulmonar como estimadores de precarga cardíaca en pacientes críticos |
| publisher |
Sociedad Médica de Santiago |
| publishDate |
2005 |
| url |
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005000600001 |
| work_keys_str_mv |
AT tomicicfvinko volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT grafsjeronimo volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT echevarriaoghislaine volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT espinozarmauricio volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT abarcazjuan volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT montessjosemiguel volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT torresmjavier volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT nunezugaston volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT guerreropjulia volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT luppinmario volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos AT canalslclaudio volumensanguineointratoracicoversuspresionarterialdeoclusionpulmonarcomoestimadoresdeprecargacardiacaenpacientescriticos |
| _version_ |
1718436207812149248 |