<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092016000200078</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Eficacia de la medición del contenido de fluido torácico por bioimpedancia torácica en la optimización del volumen intravascular en pacientes con choque séptico y su impacto en la mortalidad]]></article-title>
<article-title xml:lang="en"><![CDATA[Effectiveness of the measurement of thoracic fluid content by thoracic bioimpedance on intravascular volume optimization in patients with septic shock and its impact on mortality]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar Arzápalo]]></surname>
<given-names><![CDATA[Mario Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López Avendaño]]></surname>
<given-names><![CDATA[Víctor Gabriel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cetina Cámara]]></surname>
<given-names><![CDATA[Marco Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barradas Rodríguez]]></surname>
<given-names><![CDATA[Lorena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Agustín O&#8217;Horán  ]]></institution>
<addr-line><![CDATA[Mérida Yucatán]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General de Valladolid  ]]></institution>
<addr-line><![CDATA[Valladolid Yucatán]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>30</volume>
<numero>2</numero>
<fpage>78</fpage>
<lpage>86</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092016000200078&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092016000200078&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092016000200078&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Antecedentes:  La mortalidad asociada al choque séptico continúa siendo elevada; la reanimación hídrica y la optimización de volumen son la piedra angular en el tratamiento. Éste amerita monitoreo invasivo y mediciones estáticas, por lo que es necesario tener métodos de monitoreo no invasivos, rápidos y dinámicos. El contenido de fluido torácico por bioimpedancia torácica surge como un método de monitoreo que cumple con los requisitos: no invasivo, de fácil colocación y dinámico.  Métodos:  Se obtuvo una muestra de 60 pacientes divididos en dos grupos de 30; ingresaron a la unidad de cuidaos intensivos (UCI) con diagnóstico de choque séptico. El grupo F fue conformado por individuos en quienes se midió el contenido de fluido torácico por bioimpedancia torácica para realizar optimización del volumen intravascular; el grupo C estuvo integrado por sujetos a quienes se optimizó el volumen siguiendo las guías de EGDT (early goal-directed therapy) «Sobreviviendo a la sepsis». Se registraron la mortalidad al egreso de la UCI y a los 28 días, los días de ventilación mecánica y de estancia en la UCI.  Resultados:  Con base en el contenido de fluido torácico (CFT), en el grupo F se obtuvo una normalización de la tensión arterial media (TAM) de forma más rápida a las seis, 12 y 24 horas, con un aumento neto de la misma de 42.5% a las seis horas, comparado con el grupo C, donde se encontró a las seis horas un incremento de la TAM únicamente de 19.5% (p: &lt; 0.05). En relación con el aclaramiento de lactato, el grupo F obtuvo un aclaramiento neto de 54.4 y 66.6% a las seis y 12 horas; mientras que el grupo C mostró un aclaramiento sólo de 25.3% y 35.8% a las seis y 12 horas (p: 0.001). La mortalidad fue mayor en el grupo C, con 33.4% versus 26.7% (p: 0.001) del grupo F; a los 28 días, la mortalidad fue de 36.5 y 27.8% (p: 0.003) en el grupo C y en el F, respectivamente.  Conclusión:  La medición del contenido de fluido torácico por bioimpedancia torácica es eficaz en la optimización de volumen intravascular en pacientes con choque séptico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background: Mortality associated with septic shock is still elevated, appropriate resuscitation and intravascular volume optimization are the cornerstones in the treatment. Optimization requires invasive monitoring and static measurements; therefore, a non-invasive, fast and dynamic method to make all measures is needed. Thoracic fluid content (TFC) by thoracic bioimpedance is a monitoring system that fulfills the requirements: non-invasive, of easy placement and dynamic.  Methods:  Sixty patients were enrolled in the study and divided into two groups of 30 subjects each; all of them were admitted with a septic shock diagnosis in the ICU. Group F was formed by patients in whom TFC was measured by thoracic bioimpedance in order to guide intravascular volume optimization; Group C patients were optimized following the «Surviving Sepsis Campaign Guidelines». We recorded mortality at ICU discharge and at 28 days, length of mechanical ventilation and ICU length of stay.  Results:  Based on TFC, group F obtained a faster and higher mean blood pressure (MBP), increasing up to 42.5% at 6 hours, compared to Group C, where MBP rose only 19.5% at 6 hours (p: &lt; 0.05). Regarding lactate clearance, group F obtained a total clearance of 54.4% and 66.6% at six and 12 hours; in group C, clearance came up only to 25.3% and 35.8% at six and 12 hours (p: 0.001). A higher mortality at ICU discharge was observed in group C, with 33.4% versus 26.7% (p: 0.001) in group F, 28 day mortality was 36.5% and 27.8% (p: 0.003) in groups C and F, respectively.  Conclusion: Measurement of thoracic fluid content by thoracic bioimpedance is effective when optimizing intravascular volume in septic shock.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Contenido de fluido torácico]]></kwd>
<kwd lng="es"><![CDATA[bioimpedancia torácica]]></kwd>
<kwd lng="es"><![CDATA[optimización de volumen]]></kwd>
<kwd lng="es"><![CDATA[choque séptico]]></kwd>
<kwd lng="en"><![CDATA[Thoracic fluid content]]></kwd>
<kwd lng="en"><![CDATA[thoracic bioimpedance]]></kwd>
<kwd lng="en"><![CDATA[intravascular volume optimization]]></kwd>
<kwd lng="en"><![CDATA[septic shock]]></kwd>
</kwd-group>
</article-meta>
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