MEDICIÓN DEL DIÁMETRO DE VENA CAVA INFERIOR COMO PARTE DEL MANEJO DE LA VOLEMIA EN EL SHOCK SÉPTICO EN EL ÁREA DE TERAPIA INTENSIVA DEL HOSPITAL ALCÍVAR PERÍODO 2016 – 2017.

Abstract

Intravascular volume monitoring has been performed by invasive procedures (Swan Ganz catheter, central venous pressure), lack of precision and potential complications progressively decreased its use by ecosonography, is non-invasive and quickly verifies the patient's liquid status. Objective: To demonstrate the use of vena cava diameter measurement as part of the management of volemia in the patient in septic shock. Method: The study was observational, descriptive, prospective. Forty-three patients with septic shock were studied, including those with other pathologies who developed septic shock during their admission. We monitor direct arterial pressure, central venous pressure (CVP) and transthoracic ultrasound. We measured the vena cava inferior to the admission and after the administration of intravenous crystalloids 30 ml / kg. Results: two groups were observed, the first one responded to the administration of volume in which the initial Distensibility index was measured greater than 18% and a Variability Index greater than 12% corresponding to 29 patients and the second in whom the index was measured. Initial distensibility lower than 18% and a Variability Index lower than 12% and despite achieving TAM ≥ 65 mm Hg, 14 patients required the use of amines during the following 3 hours for not maintaining TAM.