Del RTM, López FJ, Cortes RJS, Huanca PJM

Language: Spanish
References: 30
Page: 652-661
PDF size: 266.95 Kb.

ABSTRACT

Introduction: nervovascular coupling is a proposal that involves indices of dysfunction of the autonomic nervous system. In patients with sepsis and septic shock, there is excessive activation of the sympathetic nervous system with an increase in levels of circulating endogenous catecholamines, increasing the stimulation of adrenergic receptors leading to desensitization. Stimulation has a negative chronotropic and inotropic effect; it can modify blood pressure as a secondary effect of regulating cardiac output. Objective: determine the usefulness of neuro-vascular coupling as a predictor of mortality in patients with sepsis in the intensive care unit. Material and methods: type of retrospective, descriptive, observational and longitudinal study. Results: an accuracy test was performed on the proposed indices of nerve-vascular coupling associated with dysfunction, of which AUC 0.67 was found for aortic distensibility and test validity S 0.88, E 0.55 (p 0.02) was performed. AUC wave variability 0.70 S 0.96, E 0.51 (p < 0.05). Heart rate variance AUC 0.73 S 0.72, E 0.69 (p < 0.05). Maximum ventilation test AUC 0.93, S 0.88 E 0.89 (p < 0.05). The analysis by global survival curve shows that since there is no increase in aortic distensibility as an indicator of nerve-vascular dysfunction after 15 days of hospital stay compared to admission to the intensive care unit, survival is estimated at just over 60%. Conclusions: the evaluation of the dysfunction of the autonomic nervous system with nerve-vascular coupling indices is a feasible proposal for monitoring in patients with sepsis and septic shock in the intensive care unit.

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