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Utilidad del protocolo focused assessment with transthoracic echocardiography (FATE) en la evaluación del paciente con shock / The usefulness of the (FATE) protocol focused assessment with transthoracic echocardiography in patients with shock
Liriano, Carlos; Rivero, Ludwig.
  • Liriano, Carlos; Hospital Central Universitario Dr. "Antonio María Pineda". Unidad de Cuidados Intermedios. Barquisimeto. VE
  • Rivero, Ludwig; Hospital Central Universitario Dr. "Antonio María Pineda". Unidad de Cuidados Intermedios. Barquisimeto. VE
Med. interna (Caracas) ; 36(3): 138-148, 2020. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1129863
RESUMEN
Determinar la utilidad del protocolo FATE (Focused Assessment with Transthoracic Echocardiography) en la evaluación de los pacientes en shock. ingresados al Servicio de Cuidados Intermedios del Hospital Central Universitario Dr. "Antonio María Pineda", Barquisimeto, Venezuela en el período agosto-octubre 2019,

Métodos:

se realizó un estudio descriptivo transversal, de 30 pacientes, con promedio de edad de 56,86 ± 15,85 años,

Resultados:

predominó el grupo de 71-80 años (23,33%), de sexo masculino (63,33%). Según la clasificación del shock por Weil y Shubin el 50% presentó shock distributivo (todos por sepsis), 20% cardiogénico, 16,67% hipovolémico y obstructivo. 13,33% Los principales hallazgos ecocardiográficos fueron presencia de derrame pleural bilateral (33,33%), derrame pleural unilateral (30%) y derrame pericárdico (23,33%). Además, 26,67% presentaron espesor miocárdico patológico, 33,33% dimensiones de VD-VI aumentadas, 46,67% función sistólica ventricular alterada; sumado al hecho que 70% de la contractibilidad y 60% de la visualización pulmonar eran patológicas. El valor cualitativo del protocolo FATE resultó en 43,33% soportaba la información disponible, 26,67% añadió información decisiva a la terapéutica, 23,33% agregó nueva información y 6,67% información fue pobre por mala ventana. La mortalidad a los 7 días fue de 43,33%, siendo más frecuente en pacientes con shock distributivo (61,54%), seguido de cardiogénico (23,08%) y obstructivo (15,38%), no hubo defunciones por shock hipovolémico. Los valores cualitativos del protocolo FATE en pacientes fallecidos; por shock distributivo 37,5%, soportó la información disponible y agregó nueva información, respectivamente. En cambio en 100% de los fallecidos por shock cardiogénico y obstructivo, el protocolo FATE añadió información decisiva a la terapéutica. Los resultados demuestran la importancia del Protocolo FATE en el manejo de pacientes con shock(AU)
ABSTRACT
To determine the usefulness of the FATE protocol (Focused Assessment with Transthoracic Echocardiography) in the evaluation of patients in shock admitted to the Intermediate Care Unit of the "University Hospital Antonio Maria Pineda" in Barquisimeto, Venezuela, during the period August-October 2019,

Methods:

A descriptive cross-sectional study was done, selecting 30 patients, with an average age of 56.86 ± 15.85 years; the most affected group was 71-80 years old (23.33%), with a predominance of the male sex (63.33%)

Results:

According to the classification of shock by Weil and Shubin, 50% were found to have distributive shock (all due to sepsis), 20% cardiogenic, 16.67% hypovolemic and obstructive 13.33%. The main echocardiographic findings were the presence of bilateral pleural effusion (33.33%), unilateral pleural effusion (30%) and pericardial effusion (23.33%). In addition, 26.67% presented pathological myocardial thickness, 33.33% increased RV-LV dimensions, 46.67% impaired ventricular systolic function; also, 70% of contractibility and 60% of pulmonary visualization were pathological. The qualitative value of the FATE protocol resulted in 43.33% supported the available information, 26.67% added decisive information to the therapy, 23.33% added new information and 6.67% information was poor due to a bad US window. (Mortality at 7 days was 43.33%, being more frequent in patients with distributive shock (61.54%), followed by cardiogenic (23.08%) and obstructive (15.38%); there were no deaths due to hypovolemic shock. The qualitative values of the FATE protocol in patients with distributive shock who died, was that 37.5% In contrast, in 100% of those who died by cardiogenic and obstructive shock, the FATE protocol added decisive information to the therapy.

Conclusion:

The results demonstrate the importance of the FATE Protocol in the management of patients with shock(AU)
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Shock, Cardiogenic / Blood Volume / Ultrasonography / Focused Assessment with Sonography for Trauma Type of study: Diagnostic study / Practice guideline / Observational study / Qualitative research Limits: Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Med. interna (Caracas) Journal subject: Glƒndulas End¢crinas / Horm“nios / Internal Medicine Year: 2020 Type: Article Affiliation country: Venezuela Institution/Affiliation country: Hospital Central Universitario Dr. "Antonio María Pineda"/VE

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Full text: Available Index: LILACS (Americas) Main subject: Shock, Cardiogenic / Blood Volume / Ultrasonography / Focused Assessment with Sonography for Trauma Type of study: Diagnostic study / Practice guideline / Observational study / Qualitative research Limits: Aged / Aged80 / Female / Humans / Male Language: Spanish Journal: Med. interna (Caracas) Journal subject: Glƒndulas End¢crinas / Horm“nios / Internal Medicine Year: 2020 Type: Article Affiliation country: Venezuela Institution/Affiliation country: Hospital Central Universitario Dr. "Antonio María Pineda"/VE