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2014, Número 2

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Med Crit 2014; 28 (2)


Correlación de la distensibilidad de la vena cava inferior con la presión de oclusión de la arteria pulmonar para evaluar el estado de volemia del paciente en la Unidad de Cuidados Intensivos

Jonguitud PR, Trujillo RN, Rosas BJV, Méndez RR, Villagómez OAJ

Idioma: Español
Referencias bibliográficas: 56
Paginas: 63-74
Archivo PDF: 238.52 Kb.


RESUMEN

Introducción: La piedra angular del tratamiento de los pacientes con estado de choque, ha sido la terapia con líquidos intravenosos. Sorprendentemente, la evaluación objetiva de la volemia inicial en los pacientes críticos resulta difícil, puesto que los múltiples estudios han demostrado que sólo 50% de los pacientes con inestabilidad hemodinámica responden a un reto de líquidos.
Objetivo: Reportar la correlación de la distensibilidad de la vena cava inferior y la presión de oclusión de la arteria pulmonar en pacientes críticos para evaluar la volemia inicial y la posible respuesta a líquidos.
Metodología: Es un estudio descriptivo, observacional, transversal y retrolectivo, donde se obtuvieron datos de 30 expedientes de los pacientes en estado de choque con medición de la presión de oclusión de la arteria pulmonar y la distensibilidad de la vena cava inferior mediante ultrasonografía. Se realizó un estudio de correlación por medio del coeficiente de Pearson.
Resultados: Se recabaron 30 expedientes de pacientes con una media de edad de 62 años, 70% fueron masculinos. Se encontró una correlación estadísticamente significativa entre la presión de oclusión de la arteria pulmonar y la distensibilidad de la vena cava inferior con una r de - .716 y un coeficiente de determinación de .512 (51%) y con una p < 0.001.
Conclusiones: La distensibilidad de la vena cava inferior es un adecuado predictor del estado de volemia inicial y su posible respuesta al reto de líquidos en pacientes críticos, útil en cualquier tipo de estado de choque. La distensibilidad de la vena cava inferior es un método no invasivo confiable que nos ofrece mayor seguridad en la evaluación del paciente.


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