Albumina soro gradiente (SAAG) 2. Concetração de amilase 3. Concentração de triglicérides 4. Contagem dos glóbulos vermelhos 5. Cultura para infecções. Apresentou gradiente de albumina soro-as-cite inferior a 1,1 g/dL, e citologia positiva Ascites is the first evidence of peritoneal carcinomatosis in up to 54% of. The first is that of a year-old woman with abdominal pain, ascites, de 5,6 g /L e albumina de 3,2 g/L com Gradiente Albumina Soro – Ascite (GASA) de 0,1.
|Published (Last):||13 April 2010|
|PDF File Size:||13.53 Mb|
|ePub File Size:||12.63 Mb|
|Price:||Free* [*Free Regsitration Required]|
Enrijecimento que muda de lugar 5. Albumina soro gradiente SAAG 2. In the majority of patients, cirrhosis leading to portal hypertension is the major cause. A particular value of recognizing portal hypertension as a cause of ascites is that medical management using allbumina and salt restriction is often effective in portal hypertensive patients.
Conversely, ascites due to peritoneal inflammation or malignancy alone does not respond to salt restriction and diuretics. The treatment can be attempted in an outpatient setting.
However hospitalization may be necessary in three situations:. For investigations of the cause of liver disease; 2.
Intensive education of the patient in preparing a diet limited to 88 mmol of sodium per day; 3. Careful monitoring of serum hradiente urine electrolytes and serum concentration of urea nitrogen and creatinine. At the hospital it’s important to monitoring body weight and the intake and output of fluids.
Fluid restriction is only necessary if the serum sodium concentration drops gradientee mmol per liter. It is also important to determine the sodium balance which can be approximated by monitoring intake diet, sodium-containing medications and intravenous solutions and urinary excretion because, a negative sodium balance is a predictor of weight loss.
Revista Brasília Médica
A reasonable goal for a patient without peripheral edema is a negative sodium balance with a weight loss of 0.
Most patient with cirrhotic ascites respond to dietary sodium restriction and diuretics. The combination of spironolactone and furosemide is the most effective regimen for rapid diminution of ascites. The starting dose is mg of Spironolactone and 40 mg of Furosemide together in the morning.
If there is no decrease in body weight or increase in urinary sodium excretion after two albumija three days, the doses of both drugs should be increased. The doses of medication can be increased to mg of Spironolactone per day and mg of Furosemide per day. Paracentesis of up to 1 L of fluid may provide relief of acute respiratory embarrassment gradinete to tense ascites. Removal of greater volumes and total paracentesis largest reported volume, 22,5 L are subject of discussion since some authors advocate the replacement of 10 g of albumin intravenously for each 1 L of ascitic fluid removed in order to prevent a reduction in plasma volume, abnormalities of electrolytes and creatinine.
However it is not clear if the use of albumin or others volume expanders such as Dextran affects the morbidity and mortality. The serum-ascites gradient is superior to the exsudate-transudate concept in differential diagnosis of ascites.
Ann Intern Med Diseases of the peritoneum, mesentery and omentum.
Cecil Textbook of Medicine, 20th edition. W B Saunders Company, Cirrhosis of the liver and its major sequelae.
A 74-year-old woman with peritoneal carcinomatosis: diagnosis challenges
Sections of this page. Email or Phone Password Forgot account?
See more of Unidos Venceremos on Facebook. However hospitalization may be necessary in three situations: Drugs Most patient with cirrhotic ascites respond to dietary sodium restriction and diuretics.
Diuretic-Resistant Ascites Treatment options for ascites resistant to medical therapy include: Care of axcite with ascites. New England Journal of Medicine All the information you need about Living With Hepatitis C, including the latest news about infection, transmission, symptoms, treatment.