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diagnosis hepatology ascites differential treatment analysis bacterial evaluation gastroenterology hepatic hydrothorax hyponatremia interpretation perioperative peritonitis preop preoperative prophylaxis pulmonary risk
Ascites - Differential Diagnosis and Workup Algorithm • Perform paracentesis: • Cell count and diff • Total
• Perform paracentesis ... Total protein • Fluid ... albumin and serum ... albumin • Aerobic ... • Calculate SAAG
Deciphering the SAAG - Serum to Ascites Albumin Gradient Ascites is either made in the liver sinusoid
Deciphering the SAAG ... Gradient Ascites ... in the fluid • ... #Ascites #Fluid ... #Gradient #Interpretation
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG) SAAG ≥ 1.1: - Ascitic protein
serum ascites albumin ... gradient (SAAG) ... #ascites #albumin ... #gradient #hepatology ... differential #diagnosis #algorithm
Ascites - Diagnosis and Management Summary Paracentesis studies: cell count + differential, albumin, protein, culture • Serum-ascites-albumin-gradient
Diagnosis and Management ... Serum-ascites-albumin-gradient ... (SAAG): > 1.1 g ... Ascites #Diagnosis #Management ... Summary #Hepatology #SAAG
Albumin Supplementation in Large-volume Paracentesis Administer albumin to prevent Prevention of Post-Paracentesis Circulatory Dysfunction • If LVP
in Large-volume Paracentesis ... Prevention of Post-Paracentesis ... Circulatory Dysfunction ... #Paracentesis # ... management #hepatology
Spontaneous Bacterial Peritonitis DIAGNOSTICS Paracentesis: • Calculate absolute PMN count (total WBC x PMN %) • Correct
inoculating ascitic fluid ... as 10 days 2) Albumin ... 1.5 g/kg of 25% albumin ... : lg/kg of 25% albumin ... SBP #diagnosis #management
Hepatic Hydrothorax • Presents as right sided in 85% of cases • Fluid studies:
85% of cases • Fluid ... - Pleural fluid ... - Pleural fluid ... albumin gradient ... may develop • Management
Management of Hyponatremia Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125 Give
Management of Hyponatremia ... volume • Offer Fluid ... - Correct K & Albumin ... Volume • Consider Fluid ... #algorithm #treatment
Preoperative Risk Evaluation Major Pre-Op Questions: 1. Does the patient have any modifiable risk factors that could be
any evidence of fluid ... event, follow ACC algorithm ... with valvular dysfunction ... or LV dysfunction ... medical and surgical management
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