{"id":{"repo_id":"rosario","oai_identifier":"oai:repository.urosario.edu.co:10336/4277"},"canonical_url":"https://search.dev.ndltd.org/etd/rosario/oai:repository.urosario.edu.co:10336/4277","repository":{"repo_id":"rosario","name":"Universidad del Rosario","base_url":"https://repository.urosario.edu.co/oai/request"},"display":{"title":"Perfil acido-base de pacientes con cirrosis descompensada por hemorragia digestiva alta en el departamento de emergencias: serie de casos","abstract":"Introducción: La hemorragia digestiva (HVDA) es la principal causa de descompensación en pacientes con cirrosis. Caracterizar el estado ácido-base de estos pacientes sería útil para reflejar la severidad del sangrado e identificar pacientes con alto riesgo de complicación. Objetivo: Describir el estado ácido-base de los pacientes que consultaron a urgencias con cirrosis descompensada por HVDA y posteriormente fueron manejados en la unidad de cuidado intensivo (UCI) o fallecieron. Métodos: Se realizó el análisis del estado ácido-base a 10 pacientes con estas características, utilizando tres métodos distintos. Resultados: El perfil ácido-base encontrado fue: acidosis metabólica por iones no medidos, acidosis láctica, alcalosis por hipoalbuminemia y anión gap elevado en la mayoría de pacientes. Conclusiones: La teoría de Henderson-Hasselbach no fue suficiente para identificar pacientes con alto riesgo, debería implementarse concomitantemente el análisis anión gap, base déficit y el método físico–químico, para entender los fenómenos acido base de estos pacientes.","abstract_html":"Introducción: La hemorragia digestiva (HVDA) es la principal causa de descompensación en pacientes con cirrosis. Caracterizar el estado ácido-base de estos pacientes sería útil para reflejar la severidad del sangrado e identificar pacientes con alto riesgo de complicación. Objetivo: Describir el estado ácido-base de los pacientes que consultaron a urgencias con cirrosis descompensada por HVDA y posteriormente fueron manejados en la unidad de cuidado intensivo (UCI) o fallecieron. Métodos: Se realizó el análisis del estado ácido-base a 10 pacientes con estas características, utilizando tres métodos distintos. Resultados: El perfil ácido-base encontrado fue: acidosis metabólica por iones no medidos, acidosis láctica, alcalosis por hipoalbuminemia y anión gap elevado en la mayoría de pacientes. Conclusiones: La teoría de Henderson-Hasselbach no fue suficiente para identificar pacientes con alto riesgo, debería implementarse concomitantemente el análisis anión gap, base déficit y el método físico–químico, para entender los fenómenos acido base de estos pacientes.","abstract_has_math":false,"creators":["Cortes-Puentes, Luis Arcadio","Torres Castillo, Jenny Imelda","Cortés Puentes, Gustavo","Beltrán Rodríguez, Johnny Adalber","Hernández, Geovanni","Beltrán, Oscar"],"institution":"Universidad del Rosario","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2013,"date_issued":"2013-02-18","date_published":"2013-02-18","updated_at":"2026-07-27T20:47:03Z","subjects":["cirrosis hepática","Hemorragia Digestiva","Equilibrio acido base","Ácido láctico","anion gap","Liver Cirrhosis","Gastrointestinal hemorrhage","Acid base equilibrium","Lactic acid","Cirrosis hepática::Investigaciones","Equilibrio ácido::Base","Hepatología","Medicina de urgencias"],"languages":["spa"],"rights":["info:eu-repo/semantics/closedAccess"],"rights_urls":["http://creativecommons.org/licenses/by-nc-nd/2.5/co/"],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["http://repository.urosario.edu.co/handle/10336/4277"],"render_values":[{"text":"http://repository.urosario.edu.co/handle/10336/4277","href":"http://repository.urosario.edu.co/handle/10336/4277","code":true}]}]},"links":{"outbound_url":"https://doi.org/10.48713/10336_4277","outbound_label":"DOI","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Cortes-Puentes, Luis Arcadio","Torres Castillo, Jenny Imelda","Cortés Puentes, Gustavo","Beltrán Rodríguez, Johnny Adalber","Hernández, Geovanni","Beltrán, Oscar"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2013-02-18","2013-02-25T12:18:10Z"]},{"key":"dc:publisher","label":"Institution","values":["Universidad del Rosario","Facultad de Medicina","Especialización en Medicina de Emergencias"]},{"key":"dc:type","label":"Dc Type","values":["info:eu-repo/semantics/masterThesis","info:eu-repo/semantics/acceptedVersion"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["cirrosis hepática","Hemorragia Digestiva","Equilibrio acido base","Ácido láctico","anion gap","Liver Cirrhosis","Gastrointestinal hemorrhage","Acid base equilibrium","Lactic acid","Cirrosis hepática::Investigaciones","Equilibrio ácido::Base","Hepatología","Medicina de urgencias"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["spa"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/closedAccess","http://creativecommons.org/licenses/by-nc-nd/2.5/co/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://doi.org/10.48713/10336_4277","http://repository.urosario.edu.co/handle/10336/4277"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Introducción: La hemorragia digestiva (HVDA) es la principal causa de descompensación en pacientes con cirrosis. Caracterizar el estado ácido-base de estos pacientes sería útil para reflejar la severidad del sangrado e identificar pacientes con alto riesgo de complicación. Objetivo: Describir el estado ácido-base de los pacientes que consultaron a urgencias con cirrosis descompensada por HVDA y posteriormente fueron manejados en la unidad de cuidado intensivo (UCI) o fallecieron. Métodos: Se realizó el análisis del estado ácido-base a 10 pacientes con estas características, utilizando tres métodos distintos. Resultados: El perfil ácido-base encontrado fue: acidosis metabólica por iones no medidos, acidosis láctica, alcalosis por hipoalbuminemia y anión gap elevado en la mayoría de pacientes. Conclusiones: La teoría de Henderson-Hasselbach no fue suficiente para identificar pacientes con alto riesgo, debería implementarse concomitantemente el análisis anión gap, base déficit y el método físico–químico, para entender los fenómenos acido base de estos pacientes.","Introduction: Upper gastrointestinal bleeding (HVDA) is the leading cause of acute complications among patients with cirrhosis. Characterizing the acid-base status of these patients would be of help in reflecting the severity of the bleeding and in identifying those patients under high risk for complications. Objective: To describe the acid-base status in patients who were admitted to the emergency department with decompensated cirrhosis due to upper gastrointestinal bleeding, and who were subsequently managed in the intensive care unit (ICU) or died. Methods: Acid-base status of ten selected patients (n=10) was analyzed by using three different biochemical approaches. Results: The salient acid-base profiles found in most of the patients can be summarized: metabolic acidosis due to unmeasured ions, lactic acidosis, and alkalosis due to hypoalbuminemia and elevated anion gap. Conclusions: The biochemical approach based on Henderson-Hasselbalch theory was not sufficient enough in identifying those patients under high risk for complications. As an integrated assessment, the anion-gap calculation, base-deficit estimation, and physicochemical analysis should be all performed concomitantly to improve the understanding of the acid-base status among these patients."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf","Documento"]},{"key":"dc:source","label":"Dc Source","values":["D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systemic review of 118 studies. J Hepatol 2006;44: 217–31","MLe Moine O, Adler M, Bourgeois N. Factors related to early mortality in cirrhotic patients bleeding from varices and treated by urgent sclerotherapy. Gut 1992; 33:1381–1385","Chatzicostas C, Roussomoustakaki M. A comparison of Child-Pugh, APACHE II and APACHE III scoring systems in hospital mortality of patients with liver cirrhosis. BMC Gastroenterology 2003; 3(7): 1-8","Garcia-Tsao G. Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis. Hepatology 2007; 46 (3): 922 - 938","Harvey B. Lefton R, Matthew Cohen. Diagnosis and Epidemiology of Cirrhosis. Medical Clinics of North America 2009; 93 (4): 787-799","Chiu P, Enders K. Predicting Poor Outcome from Acute Upper Gastrointestinal Hemorrhage. Gastroenterology Clinics of North America 2009","Farah A. Serum lactate and base deficit as predictors of mortality and morbidity. The American Journal of Surgery 2003; 185: 485–491","Afessa B, Kubilis P. Upper Gastrointestinal Bleeding in Patients with Hepatic Cirrhosis: Clinical Course and Mortality Prediction. The American Journal Of Gastroenterology 2000; 95(2); 484 – 489","Funk G, Doberer D. Acid-base disturbances in critically ill patients with","Charalabopoulos K, Peschos D. Alterations in Arterial Blood Parameters in Patients with Liver Cirrhosis and Ascites. International Journal of Medical Sciences.2007; 4(2): 94 – 97","Hassan H, Bacon B. Evaluation of serum anion gap in patients with liver cirrhosis of diverse etiologies. Mt Sinai J Med 2004; 71(4) :281-284","Shangraw R, Jahoor F. Effect of liver disease and transplantation on urea synthesis in humans: relationship to acid-base status. Am J Physiol Gastrointest Liver Physiol 1999; 276: 1145-1152","Gatta A, Merket C, Amodio P. Development and validation of a prognostic index predicting death after upper gastrointestinal bleeding in patients with liver cirrhosis: a multicenterstudy. Am J Gastroenterol 1994; 89(9): 1528–36","Forman L , Lucey M . Predicting the prognosis of chronic liver disease: an evolution from CHILD to MELD . Hepatology. 2001;33:473–475","Po, Henry N.; Senozan, N. M. (2001). Henderson–Hasselbach Equation: Its History and Limitations. J. Chem. Educ. 2001 78 (11): 1499–1503","Kardel T, Rasrnussen S. Blood Gases and Acid-Base Disturbances in Chronic Liver Disease. Scand j clin Lab Invest 1973; 31: 307-309","B D Adams, T A Bonzani . The anion gap does not accurately screen for lactic acidosis in emergency department patients. Emergency Medicine Journal 2006; 23: 179 - 182","Shangraw R, Rabkin J. Hepatic pyruvate dehydrogenase activity in humans: effect of cirrhosis, transplantation, and dichloroacetate. Am J Physiol Gastrointest Liver Physiol 1998; 274: 569-577","Fidkowski C, Helstrom J. Diagnosing metabolic acidosis in the critically ill: bridging the anion gap, Stewart, and base excess methods. Can J Anesth 2009; 56: 247 – 256","Park M, Pontes L. Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still out come markers?. Clinics 2006; 61(1):47-52","Story D, J. Kellum. Acid-base balance revisited: Stewart and strong ions. Seminars in Anesthesia, Perioperative Medicine and Pain 2005; 24: 9-16","Danilo T. Noritomi. Metabolic acidosis in patients with severe sepsis and septic shock: A longitudinal quantitative study. Crit Care Med 2009 Vol. 37, No. 10","instname:Universidad del Rosario","reponame:Repositorio Institucional EdocUR"]},{"key":"dc:title","label":"Title","values":["Perfil acido-base de pacientes con cirrosis descompensada por hemorragia digestiva alta en el departamento de emergencias: serie de casos"]}]}],"canonical_facts":{"dc:creator":["Cortes-Puentes, Luis Arcadio","Torres Castillo, Jenny Imelda","Cortés Puentes, Gustavo","Beltrán Rodríguez, Johnny Adalber","Hernández, Geovanni","Beltrán, Oscar"],"dc:date":["2013-02-18","2013-02-25T12:18:10Z"],"dc:description":["Introducción: La hemorragia digestiva (HVDA) es la principal causa de descompensación en pacientes con cirrosis. Caracterizar el estado ácido-base de estos pacientes sería útil para reflejar la severidad del sangrado e identificar pacientes con alto riesgo de complicación. Objetivo: Describir el estado ácido-base de los pacientes que consultaron a urgencias con cirrosis descompensada por HVDA y posteriormente fueron manejados en la unidad de cuidado intensivo (UCI) o fallecieron. Métodos: Se realizó el análisis del estado ácido-base a 10 pacientes con estas características, utilizando tres métodos distintos. Resultados: El perfil ácido-base encontrado fue: acidosis metabólica por iones no medidos, acidosis láctica, alcalosis por hipoalbuminemia y anión gap elevado en la mayoría de pacientes. Conclusiones: La teoría de Henderson-Hasselbach no fue suficiente para identificar pacientes con alto riesgo, debería implementarse concomitantemente el análisis anión gap, base déficit y el método físico–químico, para entender los fenómenos acido base de estos pacientes.","Introduction: Upper gastrointestinal bleeding (HVDA) is the leading cause of acute complications among patients with cirrhosis. Characterizing the acid-base status of these patients would be of help in reflecting the severity of the bleeding and in identifying those patients under high risk for complications. Objective: To describe the acid-base status in patients who were admitted to the emergency department with decompensated cirrhosis due to upper gastrointestinal bleeding, and who were subsequently managed in the intensive care unit (ICU) or died. Methods: Acid-base status of ten selected patients (n=10) was analyzed by using three different biochemical approaches. Results: The salient acid-base profiles found in most of the patients can be summarized: metabolic acidosis due to unmeasured ions, lactic acidosis, and alkalosis due to hypoalbuminemia and elevated anion gap. Conclusions: The biochemical approach based on Henderson-Hasselbalch theory was not sufficient enough in identifying those patients under high risk for complications. As an integrated assessment, the anion-gap calculation, base-deficit estimation, and physicochemical analysis should be all performed concomitantly to improve the understanding of the acid-base status among these patients."],"dc:format":["application/pdf","Documento"],"dc:identifier":["https://doi.org/10.48713/10336_4277","http://repository.urosario.edu.co/handle/10336/4277"],"dc:language":["spa"],"dc:publisher":["Universidad del Rosario","Facultad de Medicina","Especialización en Medicina de Emergencias"],"dc:rights":["info:eu-repo/semantics/closedAccess","http://creativecommons.org/licenses/by-nc-nd/2.5/co/"],"dc:source":["D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systemic review of 118 studies. J Hepatol 2006;44: 217–31","MLe Moine O, Adler M, Bourgeois N. Factors related to early mortality in cirrhotic patients bleeding from varices and treated by urgent sclerotherapy. Gut 1992; 33:1381–1385","Chatzicostas C, Roussomoustakaki M. A comparison of Child-Pugh, APACHE II and APACHE III scoring systems in hospital mortality of patients with liver cirrhosis. BMC Gastroenterology 2003; 3(7): 1-8","Garcia-Tsao G. Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis. Hepatology 2007; 46 (3): 922 - 938","Harvey B. Lefton R, Matthew Cohen. Diagnosis and Epidemiology of Cirrhosis. Medical Clinics of North America 2009; 93 (4): 787-799","Chiu P, Enders K. Predicting Poor Outcome from Acute Upper Gastrointestinal Hemorrhage. Gastroenterology Clinics of North America 2009","Farah A. Serum lactate and base deficit as predictors of mortality and morbidity. The American Journal of Surgery 2003; 185: 485–491","Afessa B, Kubilis P. Upper Gastrointestinal Bleeding in Patients with Hepatic Cirrhosis: Clinical Course and Mortality Prediction. The American Journal Of Gastroenterology 2000; 95(2); 484 – 489","Funk G, Doberer D. Acid-base disturbances in critically ill patients with","Charalabopoulos K, Peschos D. Alterations in Arterial Blood Parameters in Patients with Liver Cirrhosis and Ascites. International Journal of Medical Sciences.2007; 4(2): 94 – 97","Hassan H, Bacon B. Evaluation of serum anion gap in patients with liver cirrhosis of diverse etiologies. Mt Sinai J Med 2004; 71(4) :281-284","Shangraw R, Jahoor F. Effect of liver disease and transplantation on urea synthesis in humans: relationship to acid-base status. Am J Physiol Gastrointest Liver Physiol 1999; 276: 1145-1152","Gatta A, Merket C, Amodio P. Development and validation of a prognostic index predicting death after upper gastrointestinal bleeding in patients with liver cirrhosis: a multicenterstudy. Am J Gastroenterol 1994; 89(9): 1528–36","Forman L , Lucey M . Predicting the prognosis of chronic liver disease: an evolution from CHILD to MELD . Hepatology. 2001;33:473–475","Po, Henry N.; Senozan, N. M. (2001). Henderson–Hasselbach Equation: Its History and Limitations. J. Chem. Educ. 2001 78 (11): 1499–1503","Kardel T, Rasrnussen S. Blood Gases and Acid-Base Disturbances in Chronic Liver Disease. Scand j clin Lab Invest 1973; 31: 307-309","B D Adams, T A Bonzani . The anion gap does not accurately screen for lactic acidosis in emergency department patients. Emergency Medicine Journal 2006; 23: 179 - 182","Shangraw R, Rabkin J. Hepatic pyruvate dehydrogenase activity in humans: effect of cirrhosis, transplantation, and dichloroacetate. Am J Physiol Gastrointest Liver Physiol 1998; 274: 569-577","Fidkowski C, Helstrom J. Diagnosing metabolic acidosis in the critically ill: bridging the anion gap, Stewart, and base excess methods. Can J Anesth 2009; 56: 247 – 256","Park M, Pontes L. Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still out come markers?. Clinics 2006; 61(1):47-52","Story D, J. Kellum. Acid-base balance revisited: Stewart and strong ions. Seminars in Anesthesia, Perioperative Medicine and Pain 2005; 24: 9-16","Danilo T. Noritomi. Metabolic acidosis in patients with severe sepsis and septic shock: A longitudinal quantitative study. Crit Care Med 2009 Vol. 37, No. 10","instname:Universidad del Rosario","reponame:Repositorio Institucional EdocUR"],"dc:subject":["cirrosis hepática","Hemorragia Digestiva","Equilibrio acido base","Ácido láctico","anion gap","Liver Cirrhosis","Gastrointestinal hemorrhage","Acid base equilibrium","Lactic acid","Cirrosis hepática::Investigaciones","Equilibrio ácido::Base","Hepatología","Medicina de urgencias"],"dc:title":["Perfil acido-base de pacientes con cirrosis descompensada por hemorragia digestiva alta en el departamento de emergencias: serie de casos"],"dc:type":["info:eu-repo/semantics/masterThesis","info:eu-repo/semantics/acceptedVersion"]},"updated_at":"2026-07-27T20:47:03Z"}