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

Autoria(s): Suárez Reyes, Gabriel; Fino Solano, Marisol
Contribuinte(s)

Molina Castaño, Carlos Federico
Data(s)

20/09/2016

31/12/1969
Resumo

Introducción: El monitoreo hemodinámico es una herramienta para diagnosticar el choque cardiogénico y monitorear la respuesta al tratamiento; puede ser invasivo, mínimamente invasivo o no invasivo. Se realiza rutinariamente con catéter de arteria pulmonar (CAP) o catéter de Swan Ganz; nuevas técnicas de monitoreo hemodinámico mínimamente invasivo tienen menor tasa de complicaciones. Actualmente se desconoce cuál técnica de monitoreo cuenta con mayor seguridad en el paciente con choque cardiogénico. Objetivo: Evaluar la seguridad del monitoreo hemodinámico invasivo comparado con el mínimamente invasivo en pacientes con choque cardiogénico en cuidado intensivo adultos. Diseño: Revisión sistemática de la literatura. Búsqueda en Pubmed, EMBASE, OVID - Cochrane Library, Lilacs, Scielo, registros de ensayos clínicos, actas de conferencias, repositorios, búsqueda de literatura gris en Google Scholar, Teseo y Open Grey hasta agosto de 2016, publicados en inglés y español. Resultados: Se identificó un único estudio con 331 pacientes críticamente enfermos que comparó el monitoreo hemodinámico con CAP versus PiCCO que concluyó que después de la corrección de los factores de confusión, la elección del tipo de monitoreo no influyó en los resultados clínicos más importantes en términos de complicaciones y mortalidad. Dado que se incluyeron otros diagnósticos, no es posible extrapolar los resultados sólo a choque cardiogénico. Conclusión: En la literatura disponible no hay evidencia de que el monitoreo hemodinámico invasivo comparado con el mínimamente invasivo, en pacientes adultos críticamente enfermos con choque cardiogénico, tenga diferencias en cuanto a complicaciones y mortalidad.

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
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http://repository.urosario.edu.co/handle/10336/12442
Idioma(s)

spa
Publicador

Facultad de medicina
Direitos

info:eu-repo/semantics/embargoedAccess
Fonte

instname:Universidad del Rosario

reponame:Repositorio Institucional EdocUR

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Palavras-Chave #Epidemiología #614.4 #Epidemiología #Cuidados críticos #Choque #Monitoreo epidemiológico #Shock, cardiogenic #critical care #hemodynamic monitoring #catheterization Swan Ganz
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