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dc.contributor.advisorNaranjo Junoy, Francisco Fernando
dc.contributor.authorArdila Castellanos, Hugo Ricardo
dc.date.accessioned2020-06-26T19:59:26Z
dc.date.available2020-06-26T19:59:26Z
dc.date.issuedFebrero-2015
dc.identifier.urihttp://hdl.handle.net/20.500.12749/1722
dc.description.abstractExisten fundamentalmente dos tipos de edema pulmonar en humanos: el edema pulmonar cardiogénico (denominado también hidrostático o hemodinámico) y el edema pulmonar no cardiogénico (denominado de permeabilidad, injuria pulmonar aguda o SDRA) (1). Se reconoce el Síndrome de Dificultad Respiratoria Agudo (SDRA) como un tipo de injuria pulmonar difusa de inicio agudo, asociado con un factor de riesgo predisponente, caracterizado por inflamación que lleva a un aumento de la permeabilidad vascular y perdida de tejido pulmonar aireado (2). La marca clínica del síndrome es la hipoxemia acompañada de opacidades radiográficas bilaterales; asociada a alteraciones fisiológicas como incremento del shunt intrapulmonar y disminución de la compliance pulmonar. Morfológicamente se caracteriza por edema pulmonar, inflamación, membranas hialinas y hemorragia alveolar (3). Un rápido incremento en la presión hidrostática, llevando a los capilares pulmonares a un aumento de la filtración de líquido vascular al alveolo, es la marca principal del edema pulmonar cardiogénico o por sobrecarga de volumen (1); el incremento en la presión hidrostática en los capilares pulmonares es usualmente debido a la elevación de la presión venosa pulmonar por incremento de las presiones de fin de diástole del ventrículo izquierdo. El agua pulmonar extravascular es la cantidad de agua que está contenida en los pulmones, fuera de la vasculatura pulmonar, y que corresponde a la suma del líquido intersticial, alveolar, intracelular y linfático; exceptuando el líquido pleural. Este puede ser medido en la práctica clínica usando el método de termodilución transpulmonar (4). La medición del agua pulmonar extravascular a través de los índices de agua extravascular y de permeabilidad vascular, se correlacionan de forma independiente con la mortalidad en pacientes con SDRA (5), y es de gran ayuda para el manejo de los líquidos endovenosos en pacientes con edema pulmonar por sobrecarga de volumen y cardiogénico. Algunos estudios han demostrado la utilidad de la ecografía pulmonar para la medición indirecta del agua pulmonar extravascular y su correlación con técnicas de imágenes diagnósticas y con ecocardiografía, o correlación clínica (6,7,8), pero su correlación con la medición por técnica de termodilución transpulmonar no es clara.spa
dc.description.tableofcontents1. INTRODUCCIÓN ……………………………………………………………… 4 2. JUSTIFICACIÓN ………………………………………………………………. 5 3. PREGUNTA DE INVESTIGACIÓN …………………………………………. 6 4. OBJETIVOS GENERALES Y ESPECÍFICOS……………………………… 6 4.1 Objetivo general ……………………………………………………………... 6 4.2 Objetivos específicos………………………………………………………… 6 5. MARCO TEÓRICO……………………………………………………………. 7 6. METODOLOGÍA………………………………………………………………..13 6.1 Diseño del estudio…………………………………………………………….13 6.2 Población del estudio…………………………………………………………14 6.3 Definición de Variables……………………………………………………….14 6.4 Variable Resultado……………………………………………………………14 6.5 Criterios de inclusión………………………………………………………….14 6.6 Criterios de exclusión…………………………………………………………14 6.7 Muestra…………………………………………………………………………15 6.8 Recolección de la información……………………………………………….15 3 6.9 Consideraciones éticas………………………………………………………16 6.10 Costos y financiación……………………………………………………….17 7. ANÁLISIS ESTADÍSTICO…………………………………………………….18 8. RESULTADOS…………………………………………………………………18 9. DISCUSIÓN…………………………………………………………………….23 10. CONCLUSIÓN………………………………………………………………..25 11. AGRADECIMIENTOS………………………………………………………..26 12 BIBLIOGRAFIA……………………………………………………………….26spa
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.title"Ecografía pulmonar para la valoración del agua pulmonar extravascular y diagnóstico de edema pulmonar: correlación con el método de termodilución transpulmonar por PiCCO - Estudio piloto"spa
dc.title.translatedPulmonary ultrasound for the evaluation of extravascular pulmonary water and diagnosis of pulmonary edema: correlation with the method of transpulmonary thermodilution by PiCCO - Pilot studyeng
dc.degree.nameEspecialista en Medicina Crítica y Cuidado Intensivo del Adulto
dc.coverageBucaramanga (Santander, Colombia)
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNAB
dc.rights.localAbierto (Texto Completo)spa
dc.publisher.facultyFacultad Ciencias de la Salud
dc.publisher.programEspecialización en Medicina Crítica y Cuidado Intensivo del Adulto
dc.description.degreelevelEspecialización
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.localTesisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.subject.keywordsMedicine
dc.subject.keywordsCritical medicine
dc.subject.keywordsIntensive adult care
dc.subject.keywordsPulmonary edema
dc.subject.keywordsDiagnostic imaging
dc.subject.keywordsLung diseases
dc.subject.keywordsInvestigations
dc.subject.keywordsAnalysis
dc.subject.keywordsPhysiological alterations
dc.subject.keywordsLung ultrasound
dc.subject.keywordsPulmonary pathology
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponamereponame:Repositorio Institucional UNAB
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2
dc.relation.referencesArdila Castellanos, Hugo Ricardo (2015). Ecografía pulmonar para la valoración del agua pulmonar extravascular y diagnóstico de edema pulmonar: correlación con el método de termodilución transpulmonar por PiCCO - Estudio piloto. Bucaramanga (Santander, Colombia) : Universidad Autónoma de Bucaramanga UNAB
dc.relation.references1. Ware L, Matthay M. Acute pulmonary edema. N Engl J Med 2005; 353: 2788-2796
dc.relation.references2. Ferguson N, Fan E, Camporota L, Antonelli M, Anzueto A, Beale R, et Al. The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med 2012; 38:1573-1582
dc.relation.references3. Katzenstein A, Bloor C, Leibow A. Diffuse alveolar damage-The role of oxygen, shock, and related factors. A review. Am J Pathol 1976; 85:209-228
dc.relation.references4. Litton E, Morgan M. The PiCCO monitor: a review. Anaesth Intensive Care 2012; 40:393-409
dc.relation.references5. Jozwiak M, Silva S, Persichini R, Anguel N, Osman D, Richard C, et Al. Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome. Crit Care Med 2013; 41:472-480
dc.relation.references6. Corradi F, Ball L, Brusasco C, Riccio A, Baroffio M, Bovio G, et Al. Assessment of extravascular lung water by quantitative ultrasound and CT in isolated bovine lung. Resp Physiol Neurobiol 2013; 187: 244-249
dc.relation.references7. Baldi G, Gargani L, Abramo A, D’Errico L, Caramella D, Picano E, et Al. Lung water assessment by lung ultrasonography in intensive care: a pilot study. Intensive Care Med 2013; 39: 74-84
dc.relation.references8. Frassi F, Gargani L, Gligorova S, Ciampi Q, Mottola G, Picano E. Clinical and echocardiographic determinants of ultrasound lung comets. Eur J Echocardiography 2007; 8: 474-479
dc.relation.references9. Martín A, Saboya S, Patiño M, Silva J, Gómez S, Blanco J. Monitorización hemodinámica: Sistema PiCCO. Enferm Intensiva 2008; 19(3): 132-140
dc.relation.references10. Aguilar G, Belda F, Perel A. PiCCO plus: monitorización cardiopulmonar mínimamente invasiva. Rev Esp Anestesiol Reanim 2008; 55: 90-100
dc.relation.references11. Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, et Al. Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 2004; 93: 1265-1270
dc.relation.references12. Agricola E, Bove T, Oppizzi M, Marino G, Zangrillo A, Margonato A, et Al. “Ultrasound comet-tail images”: A marker of pulmonary edema. Chest 2005; 127: 1690-1695
dc.relation.references13. Picano E, Frassi F, Agricola E, Gligorova S, Gargani L, Mottola G. Ultrasound lung comets: A clinically useful sign of extravascular lung water. J Am Soc Echocardiogr 2006; 19: 356-363
dc.relation.references14. Frassi F, Gargani L, Tesorio P, Raciti M, Mottola G, Picano E. Prognostic value of extravascular lung water assessed with ultrasound lung comets by chest sonography in patients with dyspnea and/or chest pain. J Cardiac Fail 2007; 13: 830-835
dc.relation.references15. Joyner C Jr, Herman R, Reid J. Reflected ultrasound in the detection and localization of pleural effusion. JAMA 1967;5:399-402
dc.relation.references16. Lichtenstein D. Lung ultrasound in the critically ill. Annals Intensive Care 2014;4:1
dc.relation.references17. Lichtenstein D, Mezière G, Lagoueyte J, Biderman P, Goldstein I, Gepner A. A-lines and B-lines: lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill. Chest 2009;136:1014-1020
dc.relation.references18. Mitchell J, Caladrino F. Improved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization. Am Rev Respir Dis 1992;145:990-998
dc.relation.references19. Eisenberg P, Anderson D. A prospective study of lung water measurements during patient management in an intensive care unit. Am Rev Resp Dis 1987;136:662-668
dc.relation.references20. Pearce M. The measurement of pulmonary parenchymal volume by thermal indicator dilution. Clin Res 1966;14:182
dc.relation.references21. Newman E, Genecin A. The dye dilution method for describing the central circulation. An analysis of factors shaping the time-concentration curve. Circulation 1951;4:735-746
dc.relation.references22. Stewart G. Research on the circulation time in organs and on the influences which affect it. J Physiol 1897;15:1-89
dc.relation.references23. Sakka S, Reinhart K. Prognostic value of extravascular lung water in critically ill patients. Chest 2002;122:2080-2086
dc.relation.references24. Tagami T, Nakamura T, Kushimoto S, Tosa R, Watanabe A, Kaneko T, et Al. Early-phase changes of extravascular lung water index as a prognostic indicator in acute respiratory distress syndrome patients. Ann Intensive Care 2014;4:27
dc.relation.references25. Sivak E, O’Donovan P. Value of extravascular lung water measurement versus portable chest x-ray in the management of pulmonary edema. Crit Care Med 1983;11:498-501
dc.relation.references26. Fernandez-Mondejar E, García-Delgado M. Small increases in extravascular lung water are accurately detected by transpulmonary thermodilution. J Trauma 2005;59:1420-1424
dc.relation.references27. Lichtenstein D, Meziere G, Biderman P, Gepner A, Barré O. The comet-tail artifact: An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care 1997; 156: 1640-1646
dc.relation.references28. Resolución 8430 de 1993 del Ministerio de Salud en Reglamentación en Ciencia y Tecnología (1998). Ministerio de Salud, Dirección de desarrollo científico y tecnológico, República de Colombia, Bogotá, D.C.
dc.relation.references29. World Medical Association. Declaration of Helsinki 2008. http://www.wma.net/s/ethicsunit/helsinki.htm
dc.relation.references30. Lichtenstein D, Meziere G. A lung ultrasound sign allowing bedside distinction between pulmonary edema and COPD: the comet-tail artifact. Intensive Care Med 1998; 24: 1331-1334
dc.relation.references31. Monnet X, Persichini R, Ktari M, Jozwiak M, Richard C, Teboul JL. Precision of the transpulmonary thermodilution measurements. Crit Care 2011; 15: R204
dc.relation.references32. Lichtenstein D. Lung ultrasound in the critically ill. Curr Opin Crit Care 2014;20:315-322
dc.relation.references33. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein D, Mathis G, Kirkpatrick A, et Al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 2012;38:577-591
dc.relation.references34. Lichtenstein D. FALLS-protocol: lung ultrasound in hemodynamic assessment of shock. Heart Lung Vessels 2013;5(3):142-147
dc.relation.references35. Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, et Al. Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 2004;93:1265-1270
dc.relation.references36. Lichtenstein D, Mézière G, Biderman P, Gepner A, Barré O. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 1997;156:1640-1646
dc.relation.references37. Agricola E, Bove T, Oppizzi M, Marino G, Zangrillo A, Margonato A, et Al. “Ultrasound comet-Tail images”: A marker of pulmonary edema. A comparative study with wedge pressure and extravascular lung water. Chest 2005;127:1690-1695
dc.relation.references38. Bataille B, Rao G, Cocquet P, Mora M, Masson B, Ginot J, et Al. Accuracy of ultrasound B-lines score and E/Ea ratio to estimate extravascular lung water and its variations in patients with acute respiratory distress syndrome. J Clin Monit Comput 2015;29(1):169-176
dc.contributor.cvlachttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000176095
dc.contributor.researchgatehttps://www.researchgate.net/profile/Ricardo_Ardila-Castellanos
dc.subject.lembMedicinaspa
dc.subject.lembMedicina críticaspa
dc.subject.lembCuidado intensivo del adultospa
dc.subject.lembEdema pulmonarspa
dc.subject.lembDiagnóstico por imagenspa
dc.subject.lembEnfermedades de los pulmonesspa
dc.subject.lembInvestigacionesspa
dc.subject.lembAnálisisspa
dc.description.abstractenglishThere are basically two types of pulmonary edema in humans: edema cardiogenic pulmonary (also called hydrostatic or hemodynamic) and the non-cardiogenic pulmonary edema (called permeability, lung injury acute or ARDS) (1). Acute Respiratory Distress Syndrome is recognized (ARDS) as a type of acute onset diffuse lung injury associated with a predisposing risk factor, characterized by inflammation leading to a increased vascular permeability and loss of aerated lung tissue (2). The clinical mark of the syndrome is hypoxemia accompanied by opacities bilateral radiographic; associated with physiological alterations such as increased intrapulmonary shunt and decreased lung compliance. Morphologically characterized by pulmonary edema, inflammation, hyaline membranes and alveolar hemorrhage (3). A rapid increase in hydrostatic pressure, leading to the pulmonary capillaries to an increase in the leakage of vascular fluid to the alveolus, is the main mark of cardiogenic or overuse pulmonary edema volume (1); the increase in hydrostatic pressure in the capillaries pulmonary veins is usually due to elevation of pulmonary venous pressure due to an increase in left ventricular end-diastole pressures. Extravascular lung water is the amount of water that is contained in the lungs, outside the pulmonary vasculature, and which corresponds to the sum of the interstitial, alveolar, intracellular and lymphatic fluid; except for pleural fluid. This can be measured in clinical practice using the thermodilution method. transpulmonary (4). Measurement of extravascular lung water through the indices of extravascular water and vascular permeability, are correlated independently with mortality in patients with ARDS (5), and is of great help in the management of intravenous fluids in patients with edema pulmonary volume overload and cardiogenic. Some studies have proven the usefulness of lung ultrasound for indirect measurement of extravascular lung water and its correlation with techniques diagnostic images and echocardiography, or clinical correlation (6,7,8), but its correlation with the measurement by transpulmonary thermodilution technique is not clear.eng
dc.subject.proposalAlteraciones fisiológicas
dc.subject.proposalEcografía pulmonar
dc.subject.proposalPatología pulmonar
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*


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