[Hantavirus cardiopulmonary syndrome: utility of the PICCO(Pulse contour cardiac output) system for monitoring].
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.
Romero
Carlos
C
Facultad de Medicina, Hospital Clínico de la Pontificia Universidad Católica de Chile, Santiago de Chile. cmromero@puc.cl
Andresen
Max
M
Díaz
Orlando
O
Tomicic
Vinko
V
Baraona
Fernando
F
Mercado
Marcelo
M
Pérez
Carlos
C
Downey
Patricio
P
Dougnac
Alberto
A
D000368:Aged; D002302:Cardiac Output; D018804:Hantavirus Pulmonary Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D009102:Multiple Organ Failure / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology