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

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dc.contributor.authorLópez, René
dc.contributor.authorPérez-Araos, Rodrigo
dc.contributor.authorSalazar, Álvaro
dc.contributor.authorUlloa, Ana
dc.contributor.authorVial, Pablo
dc.contributor.authorVial, Cecilia
dc.contributor.authorJerónimo, Graf
dc.date.accessioned2020-09-04T19:24:26Z
dc.date.available2020-09-04T19:24:26Z
dc.date.issued2019
dc.descriptionPrograma Hantavirus, Instituto de Ciencias e Innovación en Medicina (ICIM)es
dc.description.abstractHantavirus 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.identifier.citationLópez 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/v11100900es
dc.identifier.urihttps://doi.org/10.3390/v11100900es
dc.identifier.urihttp://hdl.handle.net/11447/3404
dc.language.isoenes
dc.publisherMDPI AGes
dc.subjectAndes viruses
dc.subjectHantavirus cardiopulmonary syndromees
dc.subjectHantavirus pulmonary syndromees
dc.subjectPulmonary edemaes
dc.subjectTranspulmonary thermodilution.es
dc.subjectHantaviruses
dc.titleHemodynamic and Pulmonary Permeability Characterization of Hantavirus Cardiopulmonary Syndrome by Transpulmonary Thermodilutiones
dc.typeArticlees

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