Seguridad del monitoreo hemodinámico invasivo versus mínimamente invasivo en pacientes con choque cardiogénico en cuidado intensivo adultos. Revisión sistemática

Abstract

Background: Hemodynamic monitoring is a tool to diagnose cardiogenic shock and monitor the response to treatment; can be invasive, minimally invasive or non-invasive. It is routinely performed with pulmonary artery catheter (PAC) or Swan Ganz catheter; new techniques for minimally invasive hemodynamic monitoring have lower complication rate. monitoring technique which has increased safety in patients with cardiogenic shock is unknown. Objective: To evaluate the safety of invasive hemodynamic monitoring compared with minimally invasive in patients with cardiogenic shock in adult intensive care. Design: Systematic review of the literature. Search in PubMed, EMBASE, OVID - Cochrane Library, Lilacs, Scielo, clinical trials registers, conference proceedings, repositories, gray literature search on Google Scholar, Teseo and Open Grey until August 2016, published in English and Spanish. Results: A single study of 331 critically ill patients that compared the hemodynamic monitoring with CAP versus PiCCO which concluded that after correction for confounding factors, the choice of monitoring did not influence the most important clinical outcomes in terms was identified of complications and mortality. Since other diagnoses were included, it is not possible to extrapolate the results to only cardiogenic shock. Conclusion: In the literature there is no evidence that invasive hemodynamic monitoring compared with minimally invasive, in critically ill adult patients with cardiogenic shock, have differences in complications and mortality