Monitoreo Avanzado Paciente VMI

8/2/2019 Monitoreo Avanzado Paciente VMI

1/49


2/49

PDF created with pdfFactory trial version www.pdffactory.com
http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


3/49

MONI TOREO DEL PACI ENTE VENTI LADO MECANI CAMENTE

Monit oreo de las curvas del VM? Monit oreo hemodinmico?

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


4/49

MONI TOREOMONI TOREO

HEMODI NAMI COHEMODI NAMI CO

GC

FC VSx

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


5/49

MONI TOREOMONI TOREO

HEMODI NAMI COHEMODI NAMI CO

GC = FC x VSGC = FC x VS

GC = PAMGC = PAM PAD / RVSPAD / RVS

GC = PMAPGC = PMAP PEAP / RVPPEAP / RVP

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


6/49

TRANSPORTE DE OXIGENOTRANSPORTE DE OXIGENO

Depende del GC y del contenido d e O2Depende del GC y del contenido de O2en la sangre:en la sangre:

DO2 = GC x CaO2 x 10DO2 = GC x CaO2 x 10 (DO2 = 900(DO2 = 900-- 1000 ml/ min)1000 ml/ min)

DO2: O2 delivery (transport)DO2: O2 delivery (transport) CaO2: contenido arterial de O2 (ml/ d l)CaO2: contenido arterial de O2 (ml/ d l)

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


7/49

Ca02- CvO2: 5-6 ml

CaO2: (Hb x 1. 37 x sat O2) + (0.003 x PaO2)

CONTENI DO DE OXI GENO

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


8/49

CONSUMO DE O2 (VO2)CONSUMO DE O2 (VO2)

VO2 = GC x (CaO2 CvO2) x 10

VO2: 250 ml/min



9/49

APORTE DE OXIGENOAPORTE DE OXIGENO

DEBE EXISTIR UN EQUILIBRIO ENTRE

DO2 Y VO2 (750 ML/MIN)



10/49PDF created with pdfFactory trial version www.pdffactory.com


11/49PDF created with pdfFactory trial version www.pdffactory.com


12/49

GCGC

PrecargaPrecarga PoscargaPoscarga ContractilidadContractilidad

FCFC

LlenadoLlenadoVentricularVentricular

CargaContraccin

VSVS PVIFDPVIFD PA

RVS

TAMAOVI

VSVS= X

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


13/49

MONITOREOMONITOREO

HEMODINAMICOHEMODINAMICO

Monitoreo no invasivoMonitoreo no invasivo

Monitoreo invasivoMonitoreo invasivo

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


14/49

MONITOREOMONITOREO


Mon itoreo no invasivoMonitoreo no invasivo

Pulso (FC)Pulso (FC)

OximetrOximetra de pulsoa de pulso

PAPA (aparatos de registro automatizado)(aparatos de registro automatizado)

TT

DiuresisDiuresis

EXAMEN FISICOEXAMEN FISICO

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


15/49

MONITOREOMONITOREO


Monitoreo invasivoMonitoreo invasivo

LLnea arterialnea arterial

CCatatter venoso central (CVC)ter venoso central (CVC)

CatCatter de arteria pulmonar (Swanter de arteria pulmonar (Swan-- Ganz)Ganz)

PiCCOPiCCO

VigileoVigileo

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


16/49

MONITOREO INVASIVOMONITOREO INVASIVO

Paciente crPaciente cr ticotico

Ambiente clAmbiente clnico y fisiolnico y fisiolgico cambiantegico cambiante

La interp retaciLa in terpretacin d e los parn d e los parmetros ametros a

mon itorizar son d e u tilidad cuando vanmon itorizar son de u tilidad cuando van

asociados a un razonamiento clasociados a un razonamiento cl niconico

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


17/49

TRATAR ALTRATAR ALPACI ENTE Y NOPACI ENTE Y NO

AL MONI TORAL MONI TOR

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


18/49

MONITORIZACIONMONITORIZACION

HEMODINAMICAHEMODINAMICA

ObjetivosObjetivos

AlertarAlertar

DiagnDiagnstico continuostico continuo

PronPronsticostico

GuGu a terapa terap uticautica

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


19/49

IND ICACION ES DEIND ICACION ES DE

MO NITOREO HEMODINAMICOMON ITOREO HEMO DINAMICO

QuQu pacientes deben ser m onitorizadospacientes deben ser m onitorizadoshemodinamicamente?hemodinamicamente?

Los pacientes que desarrollan estados de bajoLos pacientes que desarrollan estados de bajodebito card iaco (gasto)debito card iaco (gasto)

Los pacientes en riesgo d e desarrollar bajo debitoLos pacientes en riesgo d e desarrollar bajo debito

La magnitud y la intensidad del monitoreoLa magnitud y la intensidad del monitoreo

dependerdepender de la patologde la patologa y cond icia y cond icin deln delpacientepaciente



20/49

PACIENTES EN RIESGO DE DESARROLLARPACIENTES EN RIESGO DE DESARROLLAR

ESTADOS DE BAJO D EBITOESTADOS DE BAJO D EBITO

Pacientes con antecedentesPacientes con antecedentescard iopu lmonares que van a sercard iopu lmonares que van a sersometidos a cirugsometidos a ciruga mayora mayor

CirugCiruga de revascularizacia de revascularizacinnmiocmiocrd ica o cirugrd ica o ciruga card iacaa card iaca

CirugCiruga abdominal mayora abdominal mayor



21/49


LLnea arterialnea arterial

MonitorizaciMonitorizacin continu an continu a

Muestra de sangre arterialMuestra de sangre arterial

ComplicacionesComplicaciones

HematomasHematomas

Trombosis arterialTrombosis arterial

Isquemia distalIsquemia distal

InfecciInfeccinn

El GC es directamen te prop orcional alEl GC es directamen te prop orcional al rea bajorea bajola curva de p resila curva de p resinn

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


22/49



23/49


CatCatter venoso cen tral (CVC)ter venoso cen tral (CVC) IndicacionesIndicaciones

Aportar volum enAportar volum en

Medida de la PVCMedida de la PVC

AdministraciAdministracin de drogas irritativasn de drogas irritativas AlimentaciAlimentacin parenteraln parenteral

HemodiHemodilisislisis

InserciInsercin d e otros catn d e otros catteres como el SG o sondasteres como el SG o sondasmarcapaso transitoriasmarcapaso transitorias

La punta d el CVC debe quedar alojada enLa punta d el CVC debe quedar alojada enla vena cava superior (Rx)la vena cava superior (Rx)

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


24/49


InserciInsercinn Yugular int ernaYugular int erna

SubclaviaSubclavia

FemoralFemoral

Yugular externaYugular externa

Complicaciones CVCComplicaciones CVC

HematomaHematoma

Hematom a con obstrucciHematom a con obstruccin vn va aa a rearea

NeumotNeumotraxrax InfecciInfeccinn

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


25/49

CVC

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


26/49


CatCatter de arteria pu lmonar (CAP)ter de arteria pu lmonar (CAP)

(Cat(Catter de Swanter de Swan Ganz)Ganz)

Analizar:Analizar:

Perfil hem odinPerfil hem odinmicomico

Clasificar la etiologClasificar la etiolog a de la hipotensia de la hipotensin y/ on y/ o

hipoperfusihipoperfusinn

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


27/49

CATETER DE ARTERIACATETER D E ARTERIA

PULMONARPULMONAR

El catEl catter comter com n es de 110 cm de largon es de 110 cm de largo

y de 5y de 5 7 French (F) de di7 French (F) de d imetrometro

externoexterno

Esta marcado a intervalos de 10 cmEsta marcado a intervalos de 10 cm

(se(seal circular negra)al circular negra)

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


28/49

El mEl m s coms com n tiene 4 vn tiene 4 vasas DistalDistal : en la pu nta d el cat: en la pu nta d el catter para medir later para m edir la

presipresin d e la arteria pulmonar y cuand o estn d e la arteria pulmonar y cuando estinflado el balinflado el baln la presin la presin en cun en cu a pu lmonara pu lmonar

ProximalProximal

: treinta cent: treinta cent

metros proximal a la pu nta,metros proximal a la pu nta,

debe localizarse en la au rdebe localizarse en la aur cula derecha y mide lacula derecha y mide lapresipresin venosa central. Tambin venosa central. Tambin se usa paran se usa parainyectar el linyectar el lquido frqu ido fr o para medir el gastoo para medir el gastocardcard acoaco

BalBalnn : para inflar el bal: para inflar el baln qu e estn qu e est localizado alocalizado a1cm de la pu nta1cm de la pu nta

TermistorTermistor : para m edir el GC: para m edir el GC

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


29/49




30/49



31/49




32/49



33/49



34/49

VARIABLESVARIABLES

HEMODINAMICASHEMODINAMICAS

Volumen sistVolumen sistlico de eyeccilico de eyeccin (VS) o Stroken (VS) o StrokeVolume eVolume e ndice sistndice sistlico de eyeccilico de eyeccin (IS)n (IS)

VS = GC/ FCVS = GC/ FC

VS: VTDVS: VTD -- VTSVTS

IS = VS/ SCIS = VS/ SC



35/49

VARIABLESVARIABLES

HEMODINAMICASHEMODINAMICAS

50-150 dinas/s/cm

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


36/49



37/49



38/49

PICCOPICCO



39/49

PICCOPICCO

El sistema PiCCOEl sistema PiCCO (Pulse Contour Cardiac(Pulse Contour Cardiac

Output),Output), ((Pulsion Medical SystemsPulsion Medical Systems,,

Munich, Alemania) es un mMunich, Alemania) es un m todo detodo de

monitoreo hemodinmonitoreo hemodinmico capaz demico capaz demedir el GC por termodilucimedir el GC por termodilucinn

transpulmonar (TDTP) y estimar latranspulmonar (TDTP) y estimar la

precarga por med io del volumenprecarga por med io del volumen

sangusangu neo intratorneo intratorcico (ITBV)cico (ITBV)

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


40/49



41/49



42/49

ITTV: ITBV + EVLW

ITTV: volumen trmico intratorcico

ITBV: volumen sanguneo intratorcico

EVLW : agua pulmonar extravascular

ITBV = GEDV + PBVGEDV: volumen telediastlico global

PBV: volumen sanguneo pulmonar

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


43/49


44/49

VIGILEOVIGILEO



45/49

VIGILEOVIGILEO

Consta de un m onitor Vigileo y un sensor FloConsta de un m onitor Vigileo y un sensor FloTrac, conectado a u nTrac, conectado a u n catcatter radial o femoralter radial o femoral ..

El sensor flo trac valora y calcula la presiEl sensor flo trac valora y calcula la presin deln delpulso arterial, siend o esta directamentepulso arterial, siend o esta directamente

proporcional al volum en sistproporcional al volumen sistlicolico Con los parCon los parmetros especmetros especficos del paciente:ficos del paciente:

edad, sexo, altura y peso: se determina laedad, sexo, altura y peso: se determina lacompliance del lecho vascularcompliance del lecho vascular

http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/http://www.pdffactory.com/


46/49



47/49



48/49



49/49

Documents

Monitoreo Avanzado Paciente VMI