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Hemodynamic and Pulmonary Permeability Characterization of Hantavirus Cardiopulmonary Syndrome by Transpulmonary Thermodilution

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dc.contributor.author López, René
dc.contributor.author Pérez-Araos, Rodrigo
dc.contributor.author Salazar, Álvaro
dc.contributor.author Ulloa, Ana
dc.contributor.author Vial, Pablo
dc.contributor.author Vial, Cecilia
dc.contributor.author Jerónimo, Graf
dc.date.accessioned 2020-09-04T19:24:26Z
dc.date.available 2020-09-04T19:24:26Z
dc.date.issued 2019-09
dc.identifier.citation López R, Pérez-Araos R, Salazar Á, et al. Hemodynamic and Pulmonary Permeability Characterization of Hantavirus Cardiopulmonary Syndrome by Transpulmonary Thermodilution. Viruses. 2019;11(10):900. Published 2019 Sep 27. doi:10.3390/v11100900 es
dc.identifier.uri https://doi.org/10.3390/v11100900 es
dc.identifier.uri http://hdl.handle.net/11447/3404
dc.description Programa Hantavirus, Instituto de Ciencias e Innovación en Medicina (ICIM) es
dc.description.abstract Hantavirus cardiopulmonary syndrome (HCPS) is characterized by capillary leak, pulmonary edema (PE), and shock, which leads to death in up to 40% of patients. Treatment is supportive, including mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO). Hemodynamic monitoring is critical to titrate therapy and to decide ECMO support. Transpulmonary thermodilution (TPTD) provides hemodynamic and PE data that have not been systematically used to understand HCPS pathophysiology. We identified 11 HCPS patients monitored with TPTD: eight on MV, three required ECMO. We analyzed 133 measurements to describe the hemodynamic pattern and its association with PE. The main findings were reduced stroke volume, global ejection fraction (GEF), and preload parameters associated with increased extravascular lung water and pulmonary vascular permeability compatible with hypovolemia, myocardial dysfunction, and increased permeability PE. Lung water correlated positively with heart rate (HR, r = 0.20) and negatively with mean arterial pressure (r = -0.27) and GEF (r = -0.36), suggesting that PE is linked to hemodynamic impairment. Pulmonary vascular permeability correlated positively with HR (r = 0.31) and negatively with cardiac index (r = -0.49), end-diastolic volume (r = -0.48), and GEF (r = -0.40), suggesting that capillary leak contributes to hypovolemia and systolic dysfunction. In conclusion, TPTD data suggest that in HCPS patients, increased permeability leads to PE, hypovolemia, and circulatory impairment. es
dc.language.iso en es
dc.publisher MDPI AG es
dc.subject Andes virus es
dc.subject Hantavirus cardiopulmonary syndrome es
dc.subject Hantavirus pulmonary syndrome es
dc.subject Pulmonary edema es
dc.subject Transpulmonary thermodilution. es
dc.subject Hantavirus es
dc.title Hemodynamic and Pulmonary Permeability Characterization of Hantavirus Cardiopulmonary Syndrome by Transpulmonary Thermodilution es
dc.type Article es


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