Utilidad de la monitorización con sistema PiCCO ® durante cirugía de resección pulmonar

Summary OBJECTIVES: To evaluate the practical utility of the PiCCO system for monitoring cardiac output and its derived variables during lung resection surgery. PATIENTS AND METHODS: Patients scheduled for lung resection surgery were enrolled. After anesthesia had been induced, a Pulsiocath catheter was placed in the femoral artery ipsilateral to the thoracotomy. The following parameters were evaluated: ease of placement of the arterial catheter, functioning of the system, and appearance of complications. When the catheter was connected to the PiCCO monitor, cardiac output and derived variables were recorded throughout the procedure. RESULTS: Fifteen patients were enrolled in the study. Placement of the catheter in the femoral artery was easy in 9 cases (60%), difficult in 4 cases (27%), and impossible in 2 cases (13%). The catheter functioned correctly in 7 patients but problems developed in 6 patients (2 cases of a poor-quality pressure curve, 1 case of a discrepancy of more than 20% in comparison with blood pressure, and 3 cases of impossibility of extracting blood samples through the arterial catheter because the patients were in a lateral decubitus position). No complications relating to arterial puncture were observed. Hemodynamic monitoring showed increased cardiac output after surgery. CONCLUSIONS: The results suggest that using the PiCCO system during lung resection surgery is of limited utility, given that problems developed in relation to 53% of the catheters. This makes the technique unreliable in the event of its being required.