Síndrome hepatopulmonar: revisión narrativa

  • Margarita R. Insuasty-Enríquez Universidad CES
  • Elizabeth M. Correa-Gutiérrez Hospital San Vicente Fundación
  • Luis G. Toro-Rendón Hospital San Vicente Fundación
Palabras clave: síndrome hepatopulmonar, cirrosis hepática, hipertensión portal, complicaciones, dilatación vascular intrapulmonar, hipoxemia.

Resumen

El síndrome hepatopulmonar es una de las tres principales condiciones pulmonares en pacientes con enfermedad hepática o hipertensión portal. Esta alteración es causada por la circulación hiperdinámica, los cortocircuitos intrapulmonares y la vasodilatación pulmonar, lo que lleva a alteraciones que generan un compromiso en el intercambio gaseoso, el cual se manifiesta como hipoxemia y aumento del gradiente alveolo arterial. El diagnóstico del síndrome hepatopulmonar consiste en demostrar las alteraciones del intercambio gaseoso, por medio del análisis de los gases arteriales, y las dilataciones vasculares intrapulmonares, documentadas por ecocardiografía transtorácica contrastada con solución salina agitada, la cual es considerada el estándar de referencia. Por el impacto pronóstico del síndrome hepatopulmonar, se recomienda una tamización activa que permita un diagnóstico temprano, y referir a tiempo al paciente a un centro especializado para la valoración de trasplante hepático como único tratamiento disponible curativo. El objetivo de este artículo es proporcionar una revisión narrativa sobre el síndrome hepatopulmonar, con énfasis en la definición, diagnóstico, fisiopatogénesis y medidas terapéuticas disponibles.

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Biografía del autor/a

Margarita R. Insuasty-Enríquez, Universidad CES

Médica, Residente en Medicina Interna, Universidad CES. Medellín, Colombia.

Elizabeth M. Correa-Gutiérrez, Hospital San Vicente Fundación

Médica, especialista en Medicina Interna, subespecialista en Hepatología y Trasplante hepático. Hepatóloga, Hospital Universitario San Vicente Fundación, sede Medellín y sede Rionegro. Medellín, Antioquia.

Luis G. Toro-Rendón, Hospital San Vicente Fundación

Médico, especialista en Medicina Interna, subespecialista en Hepatología y Trasplante hepático. Hepatológo, Hospital Universitario San Vicente Fundación, sede Medellín y sede Rionegro. Medellín, Antioquia. Grupo de Investigación en Trasplante de órganos (INTRO).

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Cómo citar
1.
Insuasty-Enríquez MR, Correa-Gutiérrez EM, Toro-Rendón LG. Síndrome hepatopulmonar: revisión narrativa. Med. Lab. [Internet]. 1 de mayo de 2017 [citado 22 de abril de 2021];23(5-6):237-48. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/39
Publicado
2017-05-01
Sección
Hepatología
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