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Asociación entre las características tempranas de la forma de onda de la fotoletismografía prehospitalaria y los
Sabrina J Schmitz1, Clifton W Callaway, Francis X Guyette
1University of Pittsburgh School of Medicine, Department of Emergency Medicine, Iroquois Building, Suite 400A, 3600 Forbes Avenue Pittsburgh, PA 15213.
Shock (Augusta, Ga.)
|February 11, 2026
Resumen
Las características de la forma de onda de la fotoletismografía (PPG), como la amplitud sistólica y el área debajo de la curva, pueden predecir la progresión del choque y las intervenciones que salvan vidas en pacientes con trauma con un índice de choque inicial normal (IS). Esto ayuda a la toma temprana de decisiones clínicas.
Área de la Ciencia:
- Cuidados intensivos para el trauma.
- Medicina de emergencia Medicina de emergencia
- El monitoreo fisiológico es el monitoreo fisiológico.
Sus antecedentes:
- Los mecanismos compensatorios en el choque influyen en las formas de onda de la fotopletismografía (PPG).
- Existe una investigación limitada sobre el uso de formas de onda del PPG prehospitalario para identificar el shock compensado.
- Hipótesis: Las características tempranas de PPG en pacientes con trauma con índice de choque normal (SI) predicen cambios posteriores en el SI y intervenciones para salvar vidas (LSI).
Objetivo del estudio:
- Para investigar el valor predictivo de las características de la forma de onda del PPG pre-hospitalario temprano.
- Para determinar si las características del PPG pueden identificar a los pacientes con trauma en riesgo de shock compensado.
- Para correlacionar las características del PPG con los cambios hemodinámicos subsiguientes y la necesidad de LSI.
Principales métodos:
- Análisis secundario de 1488 pacientes adultos con traumas de transporte médico aéreo de cuidados intensivos.
- Se incluyeron pacientes con un SI inicial normal (≤ 0,8) en los primeros 7 minutos de atención.
- Se utilizó regresión lineal multivariable para asociar las características tempranas del PPG con el cambio máximo del SI (ΔSImax) y el análisis exploratorio para el LSI.
Principales resultados:
- Beat amplitud sistólica, área debajo de la curva (AUC), y la pendiente de la espalda predijo de forma independiente ΔSImax.
- El AUC y la amplitud sistólica fueron predictivos del LSI prehospitalario.
- Estas características de la forma de onda del PPG demostraron una capacidad predictiva significativa.
Conclusiones:
- El análisis temprano de la forma de onda del PPG pre-hospitalario puede predecir la posterior descompensación hemodinámica en el trauma.
- Las características del PPG pueden guiar las decisiones críticas de triaje y tratamiento en los departamentos prehospitalarios y de emergencias.
- Esta monitorización no invasiva ofrece información valiosa sobre el estado del paciente.
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