{"id":13414,"date":"2018-03-09T08:59:41","date_gmt":"2018-03-09T08:59:41","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/sindrome-hepatopulmonar-en-candidatos-a-trasplante-hepatico-prevalencia-fisiopatologia-y-caracterizacion-clinica\/"},"modified":"2018-03-09T08:59:41","modified_gmt":"2018-03-09T08:59:41","slug":"sindrome-hepatopulmonar-en-candidatos-a-trasplante-hepatico-prevalencia-fisiopatologia-y-caracterizacion-clinica","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/sindrome-hepatopulmonar-en-candidatos-a-trasplante-hepatico-prevalencia-fisiopatologia-y-caracterizacion-clinica\/","title":{"rendered":"Sindrome hepatopulmonar en candidatos a trasplante hepatico: preValencia, fisiopatolog\u00eda y caracterizacion clinica"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Graciela Martinez Palli <\/strong><\/h2>\n<p>El sindrome hepatopulmonar (shp) ha sido definido como la triada clinica que incluye hepatopatia cronica, alteraciones del intercambio pulmonar de gases (incremento del gradiente alveolo-arterial de oxigeno (aapo2), con o sin hipoxemia), y vasodilataciones intrapulmonares. Objetivos: determinar la preValencia y las caracteristicas clinicas y pulmonares funcionales del shp en candidatos a trasplante hepatico (th) e investigar si existe alguna prueba con un poder predictivo optimo, para su diagnostico. Metodo: estudiamos prospectivamente 80 pacientes con cirrosis. Todos ellos fueron sometidos a una ecocardiografia de contraste, un examen pulmonar funcional completo y el estudio de las relaciones ventilacion\/perfusi\u00f3n (va\/q) pulmonares en caso de cumplir criteros de shp(=azpo2&gt;15 mmhg y ecocardiografia de contraste positiva para la presencia de vasodilataciones intrapulmonares). tambien incluimos 5 pacientes diagnosticados de shp en quienes coexist\u00eda una enfermedad pulmonar o cardiaca intrinseca. Resultados: 14 pacientes presentaron criterios de shp(incidencia 17,5%). Los pacientes con shp(49+-12[+-ds] a\u00f1os) presentaron mayor incidencia de ara\u00f1as vasculares, disnea y acropaquia (p menor que 0,05) y menor cantidad de difusi\u00f3n del co (dlco, 56 +- 18% ref) (p menor que 0,001) que los pacientes no-shp (n,66). La presencia de un desequilibrio va\/q leve-moderada y aumento del cortocircuito pulmonar predominaban en los pacientes con shp, pero la limitaci\u00f3n de la difusi\u00f3n al o2 solo estaba presente en el grupo de shp hipox\u00e9micos (n,8). La curva roc para la dlco mostr\u00f3 un \u00e1rea bajo la curva de 0.89. Los 5 pacientes con enfermedad cardiorrespiratoria asociada mostraron un patron circulatorio hiperdin\u00e1mico con un elevado gasto cardiaco y bajas presiones de arteria pulmonar. Las relaciones va\/q mostraban unas distribuciones similares al resto de pacientes con shp.  en conclusi\u00f3n, el shp muestra una elevada preValencia en los candidatos a t<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Sindrome hepatopulmonar en candidatos a trasplante hepatico: preValencia, fisiopatolog\u00eda y caracterizacion clinica<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Sindrome hepatopulmonar en candidatos a trasplante hepatico: preValencia, fisiopatolog\u00eda y caracterizacion clinica <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Graciela Martinez Palli <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Barcelona<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 23\/10\/2001<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Robert Rodr\u00edguez Roisin<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: vicente Arroyo perez <\/li>\n<li>\u00c1lvaro Agusti garcia navarro (vocal)<\/li>\n<li>ferran Morell brotad (vocal)<\/li>\n<li>irene Rovira canudas (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Graciela Martinez Palli El sindrome hepatopulmonar (shp) ha sido definido como la triada clinica que incluye hepatopatia [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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