Aplicaciones de la variabilidad de la frecuencia cardiaca en el triage y valoración de los pacientes traumatizados Applications of Heart Rate Variability in the Triage and Assessment of Traumatically Injured Patients. Mark L. Ryan, Chad M. Thorson, Christian A. Otero, Thai Vu, and Kenneth G. Proctor Clinical Anesthesiology Research and Practice, vol. 2011 Article ID 416590, 8 pages, 2011. doi:10.1155/2011/416590 Abstract Heart rate variability (HRV) is a method of physiologic assessment which uses fluctuations in the RR intervals to evaluate modulation of the heart rate by the autonomic nervous system (ANS). Decreased variability has been studied as a marker of increased pathology and a predictor of morbidity and mortality in multiple medical disciplines. HRV is potentially useful in trauma as a tool for prehospital triage, initial patient assessment, and continuous monitoring of critically injured patients. However, several technical limitations and a lack of standardized values have inhibited its clinical implementation in trauma. The purpose of this paper is to describe the three analytical methods (time domain, frequency domain, and entropy) and specific clinical populations that have been evaluated in trauma patients and to identify key issues regarding HRV that must be explored if it is to be widely adopted for the assessment of trauma patients. http://downloads.hindawi.com/journals/arp/2011/416590.pdf Triage en los pacientes quirúrgicos de riesgo elevado para terapia intensiva

Aplicaciones de la variabilidad de la frecuencia cardiaca en el triage y valoración de los pacientes traumatizados Applications of Heart Rate Variability in the Triage and Assessment of Traumatically Injured Patients. Mark L. Ryan, Chad M. Thorson, Christian A. Otero, Thai Vu, and Kenneth G. ProctorClinical Anesthesiology Research and Practice, vol. 2011 Article ID 416590, 8 pages, 2011. doi:10.1155/2011/416590 Abstract Heart rate variability (HRV) is a method of physiologic assessment which uses fluctuations in the RR intervals to evaluate modulation of the heart rate by the autonomic nervous system (ANS). Decreased variability has been studied as a marker of increased pathology and a predictor of morbidity and mortality in multiple medical disciplines. HRV is potentially useful in trauma as a tool for prehospital triage, initial patient assessment, and continuous monitoring of critically injured patients. However, several technical limitations and a lack of standardized values have inhibited its clinical implementation in trauma. The purpose of this paper is to describe the three analytical methods (time domain, frequency domain, and entropy) and specific clinical populations that have been evaluated in trauma patients and to identify key issues regarding HRV that must be explored if it is to be widely adopted for the assessment of trauma patients. http://downloads.hindawi.com/journals/arp/2011/416590.pdf   Triage en los pacientes quirúrgicos de riesgo elevado para terapia intensiva Triage of high-risk surgical patients for intensive care Julia B Sobol and Hannah Wunsch Critical Care 2011, 15:217    doi:10.1186/cc9999 Patients who undergo high-risk non-cardiac surgical procedures represent a large proportion of admissions to intensive care units (ICUs) in the developed world. Ideally, surgeons, anesthesiologists, and intensivists admitting surgical patients to ICUs target the patients who will benefit most from this highest level of post-operative care. However, accurately identifying which patients are at high risk of complications or death after major surgery remains difficult. For example, a recent study in the United Kingdom demonstrated that patients undergoing high-risk general surgical procedures comprised only 12.5% of surgical admissions to hospitals but over 80% of deaths, with less than 15% of these high-risk patients admitted to the ICU postoperatively . http://ccforum.com/content/pdf/cc9999.pdf

Atentamente Dr. Juan Carlos Flores-Carrillo  Anestesiología y Medicina del Dolor www.anestesia-dolor.org