<?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>S2448-89092024000700547</article-id>
<article-id pub-id-type="doi">10.35366/119525</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[El aumento de la integral velocidad-tiempo debido a una disminución de la presión positiva al final de la espiración predice la respuesta del fluido]]></article-title>
<article-title xml:lang="en"><![CDATA[The increase in velocity-time integral due to a decrease in positive end-expiratory pressure predicts fluid responsiveness]]></article-title>
<article-title xml:lang="pt"><![CDATA[Aumento da integral velocidade-tempo devido a uma diminuição da pressão positiva ao final da expiração prediz a resposta do fluido]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Parada]]></surname>
<given-names><![CDATA[Nora Mercedes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garduño López]]></surname>
<given-names><![CDATA[Jessica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Amezcua Gutiérrez]]></surname>
<given-names><![CDATA[Marcos Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alva Arroyo]]></surname>
<given-names><![CDATA[Nancy V]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zamora Gómez]]></surname>
<given-names><![CDATA[Sergio Edgar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gasca Aldama]]></surname>
<given-names><![CDATA[José Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Juárez de México  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>38</volume>
<numero>7</numero>
<fpage>547</fpage>
<lpage>551</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092024000700547&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092024000700547&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092024000700547&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  determinar la capacidad del paciente para responder a la administración Fr de volumen es fundamental durante el manejo de pacientes hemodinámicamente inestables en la unidad de cuidados intensivos (UCI), para evitar la sobrecarga de líquidos que se asocia con un aumento de la mortalidad. El aumento de la presión positiva al final de la espiración (PEEP) disminuye el volumen sistólico (VS) y se explica por la disminución del retorno venoso y la interacción corazón pulmón, lo cual podría modificar la respuesta a los líquidos.  Objetivo:  evaluar si el aumento de la integral de velocidad en el tiempo (VTI) tras un cambio en la presión positiva al final de la espiración (PEEP) predice la respuesta a volumen.  Material y métodos:  estudio prospectivo, longitudinal, comparativo, analítico. Se incluyeron pacientes ingresados a la UCI con ventilación mecánica. La respuesta a volumen se midió a través de la elevación pasiva de piernas (PLR) y del volumen sistólico medido por la VTI. La prueba de PEEP consistió en un delta de incremento y posteriormente en descenso de 5 cmH2O del PEEP, con su respectiva medición del VTI. Se analizaron las variables cuantitativas con la prueba t de Student y un modelo de regresión multivariado.  Resultados:  se ingresaron un total de 54 pacientes, de los cuales los respondedores a volumen fueron 53.7%. Se realizó un análisis multivariado donde las variables con significancia fueron: variabilidad de la integral velocidad-tiempo (VVTI) OR 2.95 (IC95% 2.4-4.71, p = 0.029), VVTI 5 OR 1.28 (IC95% 1.12-5.10, p = 0.040), VTI 10 OR 3.07 (IC95% 2.37-7.19, p = 0.021), VVTI 10 OR 3.82 (IC95% 3.51-6.43, p = 0.016), el resto de las variables perdieron significancia estadística.  Conclusiones:  la respuesta a volumen puede detectarse utilizando cambios en la ventilación mecánica, como la prueba de PEEP, utilizando la VTI del tracto de salida del ventrículo izquierdo (LVOT) como un sustituto del volumen sistólico. Además, destaca que la variabilidad del VTI es una variable que demostró significancia estadística en todas las pruebas, como predictor de respuesta a volumen.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  determining the patient&#8217;s ability to respond to volume expansion is essential during the management of hemodynamically unstable patients in the Intensive Care Unit (ICU), trying to avoid fluid overload that causes increased mortality. The increase in positive end-expiratory pressure (PEEP) decreases stroke volume (SV) and is explained by the decrease in venous return that could modify the response to fluids.  Objectives:  to evaluate whether the increase in the velocity integral over time (VTI) after a change in positive end-expiratory pressure (PEEP) predicts the volume response.  Material and methods:  prospective, longitudinal, comparative, analytical study. Patients admitted to the ICU with mechanical ventilation were included. The volume response was measured through the baseline VTI and subsequently with passive leg raising (PLR). The PEEP test consisted of a delta increase and then a 5 cmH2O decrease in PEEP, with its respective VTI measurement. Quantitative variables were analyzed using the Student t test.  Results:  a total of 54 patients were admitted, of which 53.7% were volume responders. A multivariate analysis was performed where the variables with significance were: VVTI OR 2.95 (95% CI 2.4-4.71, p = 0.029), VVTI 5 OR 1.28 (95% CI 1.12-5.10, p = 0.040), VTI 10 OR 3.07 (95% CI 2.37-7.19, p = 0.021), VVTI 10 OR 3.82 (95% CI 3.51-6.43, p = 0.016), the rest of the variables lost statistical significance.  Conclusions:  volume response can be detected using changes in mechanical ventilation; such as the PEEP test, using left ventricular outflow tract (LVOT) VTI as a surrogate for stroke volume. It is noteworthy that VTI variability was a variable that demonstrated statistical significance in all tests as a predictor of volume response.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  determinar a capacidade do paciente de responder à administração de volume é essencial durante o manejo de pacientes hemodinamicamente instáveis na Unidade de Terapia Intensiva (UTI), para evitar sobrecarga de líquidos que está associada ao aumento da mortalidade. O aumento da pressão expiratória final positiva (PEEP) diminui o volume sistólico (VS) e é explicado pela diminuição do retorno venoso e da interação coração-pulmão, o que poderia modificar a resposta aos fluidos.  Objetivos:  avaliar se o aumento na integral velocidade-tempo (IVT) após uma alteração na pressão positiva expiratória final (PEEP) prevê a resposta do volume.  Material e métodos:  estudo prospectivo, longitudinal, comparativo e analítico. Foram incluídos pacientes internados na UTI com ventilação mecânica. A resposta de volume foi medida pela elevação passiva da perna (PLR) e o volume sistólico medido pelo IVT. O teste PEEP consistiu num aumento delta e subsequente diminuição de 5 5cmH2O na PEEP, com a respectiva medição IVT. As variáveis quantitativas foram analisadas através do teste t de Student e de um modelo de regressão multivariada.  Resultados:  foram internados 54 pacientes, dos quais 53.7% responder ao volume. Foi realizada análise multivariada onde as variáveis com significância foram: VVTI OR 2.95 (IC95% 2.4-4.71, p = 0.029), VVTI 5 OR 1.28 (IC95% 1.12-5.10, p = 0.040), IVT 10 OR 3.07 (IC95% 2.37-7.19, p = 0.021), VVTI 10 OR 3.82 (IC95% 3.51-6.43, p = 0.016), as demais variáveis perderam significância estatística.  Conclusões:  a resposta do volume pode ser detectada através de alterações na ventilação mecânica; como o teste PEEP, usando IVT da via de saída do ventrículo esquerdo (VSVE) como substituto do volume sistólico. Além disso, destaca-se que a variabilidade do IVT é uma variável que demonstrou significância estatística em todos os testes, como preditora da resposta ao volume.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[respuesta a volumen]]></kwd>
<kwd lng="es"><![CDATA[integral de velocidad en el tiempo]]></kwd>
<kwd lng="es"><![CDATA[presión positiva al final de la espiración]]></kwd>
<kwd lng="en"><![CDATA[volume response]]></kwd>
<kwd lng="en"><![CDATA[velocity integral over time]]></kwd>
<kwd lng="en"><![CDATA[positive end-expiratory pressure]]></kwd>
<kwd lng="pt"><![CDATA[resposta ao volume]]></kwd>
<kwd lng="pt"><![CDATA[IVT]]></kwd>
<kwd lng="pt"><![CDATA[PEEP]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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