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Tratamiento de la Ascitis, Ascitis Refractaria y el S ndrome Hepatorenal Dr. Luis Colombato Hospital Brit nico de Bu

ASCITIS. CirrosisHipertensin portal GPVH > 10 mmHg Clnicamente significativa: Valor PronosticoPredice Desarrollo de Complicaciones. Ripoll Hepatology 2006. Ascitis. . Complicacin frecuente de la cirrosis >50%Marca paso de Compensada a DescompensadaDesarrollo mas tardo que la aparicin de vrices esofagicas Paciente cirrtico con ascitis: Hipertensin portal Descompensado, Vasodilatacion, Circulacion hiperdinamicaHipovolemia efectiva, Retencin Na, Pronstico ensombrecido.

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Tratamiento de la Ascitis, Ascitis Refractaria y el S ndrome Hepatorenal Dr. Luis Colombato Hospital Brit nico de Bu

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    1. Tratamiento de la Ascitis, Ascitis Refractaria y el Síndrome Hepatorenal Dr. Luis Colombato Hospital Británico de Buenos Aires

    4. Ascitis

    5. DISFUNCIÓN CIRCULATORIA EN LA CIRROSIS

    28. ALTERACIONES RENALES EN CIRROSIS

    34. IMPORTANCIA PRONOSTICA DE LA CAUSA DE FALLA RENAL EN PACIENTES CON CIRROSIS Causas * Frecuencia Sobrevida 3m Infecciones 213(46%) 31% Hipovolemia 149 (32%) 46% SHR 60(13%) 15% Nefropatías 41( 9%) 73% * En otros 99 pacientes las causas fueron varias

    36. Cirrosis con HTP: Exagerada VASODILATACION ESPLACNICA con VASOCONSTRICCION RENAL Subgrupo con caida relativa del gasto cardíaco (i.e., gasto cardiaco elevado pero inferior al correspondiente a la caida de postcarga) Falla CARDIO-HEPATO-RENAL = Insuficiencia Cardíaca de alto débito Ruiz del Arbol

    46. VASOCONSTRICTORES SEGUIDO DE TIPS EN EL SHR

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