Monitorización hemodinámica por ecocardiografía trans-torácica en pacientes en posoperatorio de cirugía cardiovascular

Abstract

Objective: To describe hemodynamic variables measured by transthoracic echocardiography in patients undergoing different cardiovascular surgery procedures. Materials and Methods: Observational, descriptive, prospective, single center study. Hemodynamic measurement was performed with the use of transthoracic echocardiography. Contractility variables were calculated: Cardiac output and cardiac index, volume response variables: Variation of flow velocity through the left ventricular outflow tract (LVOT), and calculation of the Pulmonary Arterial Occlusion Pressure (POAP). We described the different hemodynamic patterns found and the frequency of therapeutic changes based on these findings. Results: A total of 27 patients were studied. In 25% of patients, the study could not be performed due to technical difficulties in obtaining a good ultrasound window. In 29.6% of patients, low cardiac output was found, in 59.25% normal cardiac output was found, and in 11.1% high cardiac output was found. 59.25% of the patients were found not to respond to volume by analyzing the percentage of variation of flow through the LVOT. In 14,81%, a calculated POAP greater than 18 was found. In 74,1% of the patients, some behavioral change was made based on the hemodynamic findings. Conclusions: This study highlights the importance of alternative, non-invasive techniques in the hemodynamic evaluation of patients in the Intensive Care setting. With this technique it is possible to perform an evaluation of the main hemodynamic variables, establish a reliable diagnosis and determine a therapeutic plan.