Resumen de Síndrome cardiopulmonar por Hantavirus: utilidad de la monitorización con el sistema PiCCO
Carlos Romero P, Max Andresen H, Orlando Díaz P, Vinko Tomicic, Fernando Baraona, Marcelo Mercado F, Carlos Pérez C., Patricio Downey, Alberto Dougnac Labatut
We report a 68 years old man, farmer from the metropolitan region, admitted with a Hantavirus Cardiopulmonary Syndrome. The diagnosis was made using serologic test and was later confirmed by the Public Health Institute. He evolved to an early multiple organ failure, requiring high concentrations of oxygen and invasive ventilatory assistance, vasopressor drugs and renal replacement therapy. Swan Ganz and PiCCO were used simultaneously for hemodynamic monitoring. Treatment consisted in global support therapy, antimicrobial therapy and systemic corticosteroids. Intrathoracic blood volume was a more reliable parameter than pulmonary capillary wedge pressure for the assessment of preload. As expected in situations of increased vascular permeability, there was an increase in extravascular lung water. There was a good correlation between extravascular lung water and oxygenation parameters (PaO2/FiO2 and oxygenation index). PiCCO system may become a helpful tool in the management of patients with Hantavirus Cardiopulmonary Syndrome (Rev Méd Chile 2003; 131: 1173-78)
