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2006, Número 3

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Rev Mex Cir Pediatr 2006; 13 (3)


Hiperamonemia como complicación en Pacientes con Síndrome de Intestino Corto

Ortega-Salgado JA, Bacarreza-Nogales DV, Castillo-Aguirre AI, Ceballos-Zamora C, Mata-Miranda P

Idioma: Español
Referencias bibliográficas: 83
Paginas: 117-131
Archivo PDF: 126.13 Kb.


RESUMEN

Introducción: Las causas y los efectos deletreos de la presencia de hiperamonemia en el paciente con síndrome de intestino corto (SIC) no ha sido descrita. En el presente estudio se describen las causas y situaciones relacionadas con la elevación del amonio así como sus implicaciones.
Material y Métodos: Se realizo un estudio de casos, se recolectaron los datos de morbilidad, mortalidad, niveles de amonio sérico, pruebas de función hepática, longitud del intestino residual, niveles de albúmina, etc.
Resultados: De 25 casos de SIC en 18 se detecto hiperamonemia. En el análisis multivariado utilizando regresión lineal múltiple, la variable que se relacionó significativamente con niveles de amonio fue la longitud de intestino residual (p = 0.009). La principal disfunción hepática es la colestásis (83%), que se presento en todos los caso con intestino residual ‹ 100cm. Los pacientes con albúmina ≤ 3 mg/dl tienen 27 veces más riesgo de morir que aquellos con albúmina ‹ 3mg/dl. p = 0.02 (Fisher)
Conclusiones: Es importante el prevenir la resección masiva intestinal, así como una vez efectuada prevenir la hiperamonemia en el grupo de riesgo (Intestino residual ‹ 100cm.)


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