Hemodynamic Measurements at Different Inclinations of the Head

Comparison of CVP Values , ΔPP and Echocardiographic at Different Angles Headwaters Before and After Volume Challenge

The purpose of this study is to determine whether hemodynamic measures vary in angles bedside before and after volume challenge.

• Check if values of central venous pressure (CVP), pulse pressure variation (Δpp), heart rate (HR), mean arterial pressure ((PAM) vary in different angles headboards
• Compare values of CVP, Δpp, HR and MAP as predictors of blood volume after supply of 500 ml of 0.9% saline solution.

Inclusion Criteria:

• Being in circulatory shock and have at least one of the following criteria to identify loss of tissue perfusion: systolic blood pressure <90 mmHg or need for vasoactive drugs, urine output below 0.5 ml / kg / h.
• Being under sedation, assessed by the scale of Richmond agitation and sedation (RASS) -5, mechanically ventilated in volume control mode with tidal volume between 8 to 12 ml/kg, PEEP to 8 cm H2O.
• Tue signing the informed consent by legal guardian.

Exclusion Criteria:

• Presence cardiac arrhythmias.
• Presence of abdominal or thoracic trauma.
• Contraindication for passive elevation of the members.
• Hypoxia significant PaO2/FiO2 < or equal 100.