masterThesis
Variación de volumen sistólico como predictor de hipovolemia en pacientes pediátricos con choque séptico
Fecha
2013Autor
Piracoca Mejia, Jaime
Gonzalez Herrera, Camilo Guillermo
Institución
Resumen
Cardiovascular system involvement is common in critically ill patients therefore hemodynamic monitoring is essential for appropriate treatment aimed at therapeutic targets in this patient group . Hemodynamic monitoring of cardiac output and intravascular volume estimation are essential for the management of critically ill pediatric patients , cardiac output measurement is one of the main elements to evaluate the hemodynamic status and tissue perfusion for a patient helping guide treatment and monitor the clinical response in patients with septic shock.
Hypovolemia is a common cause of circulatory failure in patients in critical condition , finding a reliable method for measuring preload is important to guide fluid administration .
Measures have traditionally been used as a blood volume associated central venous pressure (CVP ) , heart rate (HR ) , blood pressure (BP ) and urine output . These indicators have great distraction factors that cause its value is limited and therefore have to look for more reliable alternatives .
In recent years there have been proposed dynamic parameters for evaluation of the preload , including one of the most widely studied is the measurement of stroke volume variation ( SVV ) This value is based on the concept that during inspiration, decreased venous return causes a decrease in systolic volume , which is manifested as a decrease in pulse wave : therefore in a state of hypovolemia this difference will be greater , as will become more apparent volume decreased at the end of diastole .
In adults this parameter has become a useful tool to assess volume status of patients who are in critical condition and has proven useful to predict response to fluid management in different patient populations . At present there are no studies in children comparing VVS measuring against these traditional measures blood volume .