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ACES y RUSH: Protocolos de Reanimación por Ultrasonido

La evaluación abdominal y cardíaca con ultrasonido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum estado de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock ( ACES ACES Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) y el ultrasonido rápido para shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock e hipotensión ( RUSH RUSH Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) son estudios de ultrasonido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el punto de atención ( POCUS POCUS Focused Assessment with Sonography for Trauma (FAST), por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) indicados en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos de hipotensión no traumática, indiferenciada o shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock. En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la hipotensión, el diagnóstico oportuno y la terapia dirigida son esenciales para obtener resultados óptimos y conducir a una disminución de la mortalidad. Tanto el protocolo ACES ACES Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols como el RUSH RUSH Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols examinan las cavidades torácica y abdominal mediante ultrasonido para evaluar rápidamente las causas reversibles del shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock y aumentar las probabilidades de un diagnóstico preciso. Cada uno de estos protocolos combinan muchos de los LOS Neisseria mismos elementos centrales del ultrasonido, que difieren principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la secuencia de la evaluación.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Descripción General

Antecedentes

  • Los LOS Neisseria antecedentes y el examen físico a menudo carecen de la sensibilidad y especificidad necesarias para diagnosticar una patología aguda de forma precisa.
  • El ultrasonido está siendo integrado de forma temprana dentro de los LOS Neisseria esfuerzos de reanimación por su:
    • Velocidad
    • Facilidad de uso
    • Costo
    • Disponibilidad
    • Buena sensibilidad y especificidad
  • Para el cuidado de casos críticos, recientemente se han desarrollado múltiples protocolos de reanimación por ultrasonido, incluidos ACES ACES Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols y RUSH RUSH Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols.
  • El ultrasonido al AL Amyloidosis lado de la cama del paciente permite una evaluación rápida de las causas reversibles de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock y mejora la precisión del diagnóstico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la hipotensión indiferenciada.

Fundamentos del ultrasonido

  • Imagenología:
    • El ultrasonido es una técnica de imagenología basada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ultrasonidos (ondas de sonido inaudibles de alta frecuencia).
    • En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la imagenología médica, las ondas sonoras tienen una frecuencia de 2 a 18 megahercios (MHz).
    • El equipo de ultrasonido utiliza un transductor que actúa como emisor y receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de ondas de sonido y una computadora central que procesa las señales eléctricas para generar una imagen.
  • Terminología:
    • Hiperecoico (e.g., superficie del hueso, cálculos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las vías urinarias, lesiones que contienen tejido adiposo): una estructura que produce un eco de gran amplitud (grises más claros y blanco)
    • Hipoecoico (e.g., abscesos sin gas, tumores sólidos sin calcificaciones ni grasa): estructura que produce un eco de baja amplitud (grises más oscuros)
    • Anecoico (e.g., quistes simples): una estructura que no produce ningún eco (se observa completamente negra)
    • Isoecoico: una estructura que produce un eco de una amplitud muy similar a su entorno y es muy difícil de distinguir
  • Sondas:
    • Sonda curvilínea o convexa:
      • “Sonda abdominal”
      • 2–5 MHz (frecuencia baja)
      • Alta penetración
      • Gran huella
      • Poco adecuada para el movimiento
      • Se utiliza para la mayoría de los LOS Neisseria órganos internos, aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy, abdomen, pulmón, pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura: Anatomy, ginecología
    • Sonda de matriz en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum fase:
      • “Sonda cardiaca”
      • 1–5 MHz (baja frecuencia)
      • Alta penetración
      • Pequeña huella
      • Ideal para el movimiento
      • Usos: cardíaco, pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura: Anatomy
    • Sonda lineal:
      • “Sonda vascular”
      • Sonda de 6–13 MHz (alta frecuencia)
      • Baja penetración
      • Gran huella
      • Usos: vascular, pleural, nervio óptico, acceso venoso

Evaluación Abdominal y Cardíaca con Ultrasonido en Estado de Shock (ACES)

Definición

La evaluación abdominal y cardíaca con ultrasonido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum estado de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock es un examen POCUS POCUS Focused Assessment with Sonography for Trauma (FAST) utilizado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos de hipotensión indiferenciada no traumática realizada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sala de emergencias.

Principios

  • El protocolo consta de 6 ventanas que incluyen la ventana cardíaca, peritoneal, pleural, vena cava inferior (VCI) y aórtica.
  • El objetivo es acortar el tiempo que lleva establecer un diagnóstico y brindar una terapia precoz y dirigida por objetivos.
  • Indicaciones:
    • Hipotensión/ shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock no traumático
      • Hipovolémico
      • Obstructivo
      • Cardiogénico
      • Distributivo
    • Contraindicaciones:
      • Sin contraindicaciones absolutas
      • No debe retrasar los LOS Neisseria esfuerzos de reanimación

Protocolo

  1. Ventana cardiaca:
    • Ventana transversal subxifoidea de 4 cámaras
    • Evalúa la función cardíaca y el derrame/taponamiento pericárdico
  2. Vena cava inferior:
    • Ventana subxifoideoa longitudinal
    • Medición de diámetro e índice de colapso
  3. Tamizaje de la aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy abdominal:
    • Deslizamiento ligeramente a la izquierda de la línea media desde el diafragma hasta su bifurcación
    • Buscar aneurisma aórtico abdominal ( AAA AAA An aortic aneurysm is the abnormal dilation of a segment of the aorta. Abdominal aortic aneurysm is the most common aortic aneurysm, occurring frequently in the infrarenal area. Most aneurysms are asymptomatic, but can cause compression of surrounding structures or rupture, which is a life-threatening emergency. Abdominal Aortic Aneurysms).
  4. Bolsa de Morison (fosa hepatorrenal) y ventana de la base del pulmón ipsolateral:
    • Buscar peritoneo libre.
    • Buscar líquido pleural.
  5. Ventana de fosa esplenorrenal y base pulmonar:
    • Buscar peritoneo libre.
    • Buscar líquido pleural
  6. Ventana pélvica:
    • Evaluar el volumen de la vejiga
    • Buscar líquido pélvico libre.
Evaluación Abdominal y Cardíaca con Ecografía en Shock protocol-01

Protocolo de evaluación abdominal y cardíaca con ultrasonido en estado de shock (ACES):
1: 1 o más ventanas cardíacas
2: Ventana de la vena cava inferior
3: Tamizaje de la aorta abdominal
4: Derecha y 5: Ventanas del flanco izquierdo para líquido pleural y peritoneal
6: Ventana pélvica para el tamaño de la vejiga y el líquido libre

Imagen por Lecturio.
Tabla: Protocolo ACES ACES Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols: Posibles hallazgos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum estados de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock
Tipo de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock Estructuras cardíacas VCI Aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy Líquido peritoneal/sangre Líquido pleural/sangre
Séptico VI hiperdinámico o hipodinámico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock tardía VCI estrecha/colapsada Normal Sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock quirúrgica/ginecológica Neumonía, empiema
Cardiogénico VI hipodinámico/↓ FE Normal Normal Normal Normal
Hipovolémico VI hiperdinámico VCI estrecha/colapsada AAA AAA An aortic aneurysm is the abnormal dilation of a segment of the aorta. Abdominal aortic aneurysm is the most common aortic aneurysm, occurring frequently in the infrarenal area. Most aneurysms are asymptomatic, but can cause compression of surrounding structures or rupture, which is a life-threatening emergency. Abdominal Aortic Aneurysms Ruptura esplénica espontánea, víscera perforada, hemorragia ginecológica Normal
Obstructivo (cardíaco) Derrame pericárdico, taponamiento cardíaco VCI variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables Normal Normal Normal
Obstructivo (pulmonar) VD dilatado, ↑ relación VI/VD VCI dilatada Normal Normal Normal
AAA: aneurisma de aorta abdominal
VCI: vena cava inferior
VI: ventrículo izquierdo
VD: ventrículo derecho
FE: fracción de eyección

Ultrasonido Rápido para Shock e Hipotensión (RUSH)

Definición

El ultrasonido rápido para shock e hipotensión es un protocolo de examen POCUS que se enfoca en la evaluación del corazón y los vasos principales que se divide en 3 pasos: “bomba”, “depósito” y “tuberías”.

Principio

  • El líquido libre dentro de la cavidad peritoneal se asentará en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum áreas de desnivel dentro del peritoneo cuando el paciente esté en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum decúbito supino, lo que puede detectarse mediante la imagenología por ultrasonido.
  • Un protocolo de ultrasonido de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock fácil de aprender y realizar rápidamente
  • El objetivo es identificar rápidamente las causas del shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock y comenzar una terapia precoz y dirigida por objetivos.
  • Indicaciones:
    • Hipotensión/ shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock no traumático
      • Hipovolémico
      • Obstructivo
      • Cardiogénico
      • Distributivo
    • Contraindicaciones:
      • Sin contraindicaciones absolutas
      • No debe retrasar los LOS Neisseria esfuerzos de reanimación.

Protocolo

  1. Bomba (ventana cardiaca):
    • Pregunta: ¿Funciona la bomba?
    • Pericardio (derrame pericárdico/taponamiento)
    • Ventrículo izquierdo (tamaño y estado de contractilidad)
    • Tamaño relativo del ventrículo izquierdo al AL Amyloidosis ventrículo derecho
  2. Depósito (estado de volumen):
    • Pregunta: ¿Está el depósito lleno, con fugas o dañado?
    • Plenitud del depósito: evaluación de las venas cava inferior y yugular para el tamaño y el colapso con la inspiración
    • Fuga del depósito (pérdida de sangre, extravasación de líquido u otras colecciones de líquido patológico): ventanas de las fosas hepatorrenal, esplenorrenal y vejiga para evaluar colecciones intraperitoneales y derrame pleural
    • Compromiso del depósito: evaluar ambos hemitórax para neumotórax
    • Sobrecarga del depósito: evaluar ambos hemitórax para edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema pulmonar
  3. Tuberías (arterias y venas):
    • Pregunta: ¿Están las tuberías obstruidas o bloqueadas?
    • Evaluación sistemática de las principales arterias y venas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum busca de anomalías:
      • Tuberías rotas: AAA AAA An aortic aneurysm is the abnormal dilation of a segment of the aorta. Abdominal aortic aneurysm is the most common aortic aneurysm, occurring frequently in the infrarenal area. Most aneurysms are asymptomatic, but can cause compression of surrounding structures or rupture, which is a life-threatening emergency. Abdominal Aortic Aneurysms, disección aórtica
      • Tuberías obstruidas: trombosis venosa profunda (TVP)
Colocación de la sonda para el examen RUSH-01

Colocación de la sonda para el examen rápido de ultrasonido para shock e hipotensión (RUSH)

Imagen por Lecturio.
Tabla: Protocolo RUSH RUSH Abdominal and cardiac evaluation with sonography in shock (ACES) and rapid ultrasound for shock and hypotension (RUSH) are point-of-care ultrasound (POCUS) examinations indicated in cases of nontraumatic, undifferentiated hypotension, or shock. ACES and RUSH: Resuscitation Ultrasound Protocols: Posibles hallazgos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum estado de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock
Tipo de shock Shock Shock is a life-threatening condition associated with impaired circulation that results in tissue hypoxia. The different types of shock are based on the underlying cause: distributive (↑ cardiac output (CO), ↓ systemic vascular resistance (SVR)), cardiogenic (↓ CO, ↑ SVR), hypovolemic (↓ CO, ↑ SVR), obstructive (↓ CO), and mixed. Types of Shock Bomba Depósito Tubería
Cardiogénico VI hipodinámico, ↓ FE, corazón dilatado VCI dilatada, venas yugulares distendidas, cohetes pulmonares, líquido pleural, líquido peritoneal Normal
Hipovolémico VI hiperdinámico, tamaño pequeño de las cámaras VCI estrecha, venas yugulares planas, líquido peritoneal, líquido pleural Normal
Obstructivo VI hiperdinámico, derrame pericárdico, taponamiento cardíaco, distensión del VD, trombo cardíaco VCI dilatada, venas yugulares distendidas, ausencia de deslizamiento pulmonar (neumotórax) TVP
Distributivo VI hiperdinámico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock aguda, VI hipodinámico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock tardía VCI normal/pequeña ( sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock aguda), líquido peritoneal ( sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock), líquido pleural ( sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock) Normal
AAA: aneurisma de aorta abdominal
VCI: vena cava inferior
VI: ventrículo izquierdo
VD: ventrículo derecho
FE: fracción de eyección
TVP: trombosis venosa profunda

Relevancia Clínica

  • Ultrasonido: Una técnica de imagenología basada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ultrasonidos (ondas de sonido inaudibles de alta frecuencia). En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la imagenología médica, las ondas sonoras tienen una frecuencia de 2 a 18 MHz. El equipo utiliza un transductor que actúa como emisor y receptor Receptor Receptors are proteins located either on the surface of or within a cell that can bind to signaling molecules known as ligands (e.g., hormones) and cause some type of response within the cell. Receptors de las ondas sonoras y una computadora central que procesa las señales eléctricas para generar una imagen. Las ventajas generales de este tipo de imagenologías son su bajo costo, disponibilidad y seguridad.
  • Hemopericardio (taponamiento): La acumulación del exceso de líquido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el espacio pericárdico alrededor del corazón que aumenta la presión restringiendo el llenado cardíaco y resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una disminución del gasto cardíaco. Los LOS Neisseria síntomas incluyen disnea, hipotensión, ruidos cardíacos apagados, distensión venosa yugular y pulso paradójico. El diagnóstico se confirma mediante ultrasonido. El tratamiento es pericardiocentesis Pericardiocentesis Puncture and aspiration of fluid from the pericardium. Cardiac Surgery emergente o pericardiotomía.
  • Hemotórax: Acumulación de sangre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la cavidad pleural. El hemotórax ocurre más comúnmente debido al AL Amyloidosis daño a las arterias intercostales. Los LOS Neisseria pacientes presentan dificultad para respirar, dolor Dolor Inflammation torácico, hipotensión, taquicardia, disminución de los LOS Neisseria ruidos pulmonares y matidez a la percusión del tórax. El diagnóstico se realiza por medio de radiografía de tórax. Se trata por medio de un tubo de drenaje por toracostomía, cirugía toracoscópica asistida por video (VATS, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) o toracotomía.
  • Neumotórax: Una afección potencialmente mortal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la que se acumula aire en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el espacio pleural, lo que provoca el colapso del pulmón. Los LOS Neisseria pacientes presentan dolor Dolor Inflammation torácico, disnea y disminución de los LOS Neisseria ruidos respiratorios. El diagnóstico se realiza mediante imagenología, aunque el neumotórax a tensión es un diagnóstico clínico. El tratamiento se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tamaño y la estabilidad del paciente y puede incluir la descompresión con aguja y la colocación de un tubo torácico (toracostomía).
  • Derrame pleural: La acumulación de líquido entre las capas de la pleura Pleura The pleura is a serous membrane that lines the walls of the thoracic cavity and the surface of the lungs. This structure of mesodermal origin covers both lungs, the mediastinum, the thoracic surface of the diaphragm, and the inner part of the thoracic cage. The pleura is divided into a visceral pleura and parietal pleura. Pleura: Anatomy parietal Parietal One of a pair of irregularly shaped quadrilateral bones situated between the frontal bone and occipital bone, which together form the sides of the cranium. Skull: Anatomy y visceral. Las causas comunes de esta condición incluyen infección, malignidad, trastornos autoinmunes o sobrecarga de volumen. Las manifestaciones clínicas incluyen dolor Dolor Inflammation torácico, tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome y disnea. El tratamiento depende de la afección subyacente y de sí el derrame está causando dificultad respiratoria.

Referencias

  1. Alpert E. A. (2019). The ABCDs of ResUS – Resuscitation Ultrasound. Cureus, 11(5), e4616.
  2. Atkinson, P. R., McAuley, D. J., Kendall, R. J., Abeyakoon, O., Reid, C. G., Connolly, J., & Lewis, D. (2009). Abdominal and Cardiac Evaluation with Sonography in Shock (ACES): an approach by emergency physicians for the use of ultrasound in patients with undifferentiated hypotension. Emergency medicine journal: EMJ, 26(2), 87–91. 
  3. Nicks B. A., & Gaillard J. P. (2020). Approach to nontraumatic shock. Tintinalli J. E., & Ma O, & Yealy D. M., & Meckler G. D., & Stapczynski J, & Cline D. M., & Thomas S. H. (Eds.), Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw-Hill.
  4. Cardiac ultrasound. Baston C. M., & Moore C, & Krebs E. A., & Dean A. J., & Panebianco N (Eds.), (2018). Pocket Guide to POCUS: Point-of-Care Tips for Point-of-Care Ultrasound. McGraw-Hill.
  5. Fritz D. A. (2017). Emergency bedside ultrasound. Stone C, & Humphries R. L. (Eds.), CURRENT Diagnosis & Treatment: Emergency Medicine, 8e. McGraw-Hill. 
  6. Perera, P., Mailhot, T., Riley, D., & Mandavia, D. (2010). The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Emergency medicine clinics of North America, 28(1), 29–vii.

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