Descripción del estado ácido base por modelo de Stewart en pacientes postoperatorio de trasplante hepático

Abstract

Abstract Introduction: Patients after liver transplantation have multiple hemodynamic changes and electrolyte disturbances that generate changes in acid-base status. This paper seeks to describe the acid-base behavior in patients after liver transplantation through the analysis of Stewart model, focused on etiological search of each disorder and suggesting possible ways to optimize the management in Intensive Care (ICU). Methodology: Observational, descriptive, retrospective Trial, of the arterial blood gases for patients in postoperative liver transplant for any reason, played by Stewart method. It is with the universe of patients admitted in 2014 in La Fundaciòn Santa Fe de Bogotà. Results: A total of 24 patients were included, from 1 January to 31 September 2014. The median pH was 7.36 with a minimum value of 7.05 and maximum of 7.49. 41% of patients on admission to intensive care with normal lactate (less than 2), and 88% had low levels of albumin. The most common electrolyte disorder was hyperchloremia (58%), followed by hypomagnesemia (25%). Conclusions: Arterial blood gas analysis by Stewart model allows a diagnosis of a specific disorder and additionally, allows you to search the etiology of the disorder. This case series showed that 95% of patients had a metabolic disorder on admission, the most frequent metabolic acidosis (66%).