{"id":29324,"date":"2026-02-03T18:00:00","date_gmt":"2026-02-03T21:00:00","guid":{"rendered":"https:\/\/www.grupomedcof.com.br\/blog\/?p=29324"},"modified":"2026-01-28T16:40:20","modified_gmt":"2026-01-28T19:40:20","slug":"encefalopatia-hepatica-e-sindrome-hepatorrenal","status":"publish","type":"post","link":"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/","title":{"rendered":"Encefalopatia Hep\u00e1tica e S\u00edndrome Hepatorrenal"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_74 counter-hierarchy ez-toc-counter ez-toc-transparent ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Sum\u00e1rio<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar tabela de conte\u00fado\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Fisiopatologia\" >Fisiopatologia<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Diagnostico_Clinico_Criterios_de_West_Haven\" >Diagn\u00f3stico Cl\u00ednico: Crit\u00e9rios de West Haven<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#A_Regra_de_Ouro\" >A Regra de Ouro<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Tratamento_da_Encefalopatia\" >Tratamento da Encefalopatia<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Medidas_Gerais_e_Nutricao\" >Medidas Gerais e Nutri\u00e7\u00e3o<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Medicamentos_Especificos\" >Medicamentos Espec\u00edficos<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Sindrome_Hepatorrenal_SHR\" >S\u00edndrome Hepatorrenal (SHR)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Como_diagnosticar_Criterios_ICA-AKI\" >Como diagnosticar? (Crit\u00e9rios ICA-AKI)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#Tratamento_da_Sindrome_Hepatorrenal\" >Tratamento da S\u00edndrome Hepatorrenal<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.grupomedcof.com.br\/blog\/encefalopatia-hepatica-e-sindrome-hepatorrenal\/#O_metodo_que_te_aprova\" >O m\u00e9todo que te aprova!<\/a><\/li><\/ul><\/nav><\/div>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-1024x576.png\" alt=\"\" class=\"wp-image-29327\" srcset=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-1024x576.png 1024w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-300x169.png 300w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-768x432.png 768w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-1536x864.png 1536w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-2048x1152.png 2048w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-747x420.png 747w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-150x84.png 150w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-696x392.png 696w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-1068x601.png 1068w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Blog-MedCof-2024-08-30T134838.365-1920x1080.png 1920w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>A<strong> cirrose hep\u00e1tica<\/strong> culmina em duas grandes vias fisiopatol\u00f3gicas: a <strong>Hipertens\u00e3o Portal<\/strong> e a <strong>Insufici\u00eancia Hep\u00e1tica.<\/strong> A<strong> Encefalopatia Hep\u00e1tica <\/strong>(EH) \u00e9 uma manifesta\u00e7\u00e3o neuropsiqui\u00e1trica potencialmente revers\u00edvel decorrente da fal\u00eancia hep\u00e1tica e dos <em>shunts<\/em> portossist\u00eamicos.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-fisiopatologia\"><span class=\"ez-toc-section\" id=\"Fisiopatologia\"><\/span><strong><strong>Fisiopatologia<\/strong><\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>O f\u00edgado doente falha em <strong>depurar toxinas<\/strong>. A principal delas \u00e9 a <strong>am\u00f4nia<\/strong> (produzida pela atividade bacteriana intestinal). Como o f\u00edgado n\u00e3o metaboliza e os shunts desviam o sangue da circula\u00e7\u00e3o portal direto para a sist\u00eamica, essas toxinas atingem o c\u00e9rebro, causando edema e disfun\u00e7\u00e3o neuronal.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-diagnostico-clinico-criterios-de-west-haven\"><span class=\"ez-toc-section\" id=\"Diagnostico_Clinico_Criterios_de_West_Haven\"><\/span><strong><strong>Diagn\u00f3stico Cl\u00ednico: Crit\u00e9rios de West Haven<\/strong><\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>O diagn\u00f3stico \u00e9 eminentemente cl\u00ednico. Usamos a classifica\u00e7\u00e3o de West Haven para estadiar a gravidade:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Grau I:<\/strong> Paciente orientado, mas com altera\u00e7\u00e3o do sono (troca do dia pela noite), d\u00e9ficit de aten\u00e7\u00e3o ou decl\u00ednio cognitivo leve.<\/li>\n\n\n\n<li><strong>Grau II (O divisor de \u00e1guas):<\/strong> Desorientado no tempo\/espa\u00e7o. O marco f\u00edsico \u00e9 o <strong>Flapping<\/strong> (asterixis) e a dispraxia (dificuldade motora).<\/li>\n\n\n\n<li><strong>Grau III:<\/strong> Sonol\u00eancia importante (torpor), maior desorienta\u00e7\u00e3o.<\/li>\n\n\n\n<li><strong>Grau IV:<\/strong> Coma.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"748\" height=\"514\" src=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-12.png\" alt=\"\" class=\"wp-image-41167\" srcset=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-12.png 748w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-12-300x206.png 300w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-12-611x420.png 611w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-12-150x103.png 150w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-12-218x150.png 218w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-12-696x478.png 696w\" sizes=\"auto, (max-width: 748px) 100vw, 748px\" \/><figcaption class=\"wp-element-caption\">Fonte: <a href=\"https:\/\/utiprotocolos.com.br\/graus-estagios-da-encefalopatia-hepatica\/\">https:\/\/utiprotocolos.com.br\/graus-estagios-da-encefalopatia-hepatica\/<\/a>\u00a0<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-a-regra-de-ouro\"><span class=\"ez-toc-section\" id=\"A_Regra_de_Ouro\"><\/span><strong><strong>A Regra de Ouro<\/strong><\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>A EH raramente acontece &#8220;do nada&#8221;. Sempre existe um gatilho descompensando o paciente. A miss\u00e3o no PS \u00e9 investigar a causa:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Iatrog\u00eanicas:<\/strong> Uso de <strong>Benzodiazep\u00ednicos<\/strong> (evitar ao m\u00e1ximo!), sedativos e excesso de diur\u00e9ticos.<\/li>\n\n\n\n<li><strong>Infecciosas:<\/strong> PBE (Peritonite Bacteriana Espont\u00e2nea), ITU, Pneumonia. <em>Dica:<\/em> Sempre fa\u00e7a paracentese diagn\u00f3stica se houver ascite.<\/li>\n\n\n\n<li><strong>Gastrointestinais:<\/strong> Hemorragia Digestiva (o sangue \u00e9 prote\u00edna digerida, o que gera muita am\u00f4nia) e <strong>Constipa\u00e7\u00e3o<\/strong> (aumenta o tempo de absor\u00e7\u00e3o das toxinas).<\/li>\n\n\n\n<li><strong>Renais\/Metab\u00f3licas:<\/strong> Desidrata\u00e7\u00e3o, Insufici\u00eancia Renal, Hipocalemia (DHE), Hipoglicemia.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-tratamento-da-encefalopatia\"><span class=\"ez-toc-section\" id=\"Tratamento_da_Encefalopatia\"><\/span><strong><strong>Tratamento da Encefalopatia<\/strong><\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>O tratamento se baseia em tr\u00eas pilares: Suporte Geral, Tratamento do Gatilho e Redu\u00e7\u00e3o da Am\u00f4nia.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-medidas-gerais-e-nutricao\"><span class=\"ez-toc-section\" id=\"Medidas_Gerais_e_Nutricao\"><\/span><strong>Medidas Gerais e Nutri\u00e7\u00e3o<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Estabiliza\u00e7\u00e3o (prote\u00e7\u00e3o de via a\u00e9rea se graus III\/IV &#8211; considerar SNE).<\/li>\n\n\n\n<li><strong>Suspender diur\u00e9ticos<\/strong> imediatamente.<\/li>\n\n\n\n<li><strong>N\u00e3o restringir prote\u00edna!<\/strong> O paciente deve receber dieta normoproteica (1.2 a 1.5 g\/kg\/dia) para evitar o catabolismo muscular (o m\u00fasculo ajuda a metabolizar am\u00f4nia).<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-medicamentos-especificos\"><span class=\"ez-toc-section\" id=\"Medicamentos_Especificos\"><\/span><strong>Medicamentos Espec\u00edficos<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Lactulona (Dissacar\u00eddeo n\u00e3o absorv\u00edvel):<\/strong> \u00c9 o carro-chefe.\n<ul class=\"wp-block-list\">\n<li><em>Mecanismo:<\/em> Acidifica o l\u00famen intestinal, convertendo Am\u00f4nia (NH3 &#8211; absorv\u00edvel) em Am\u00f4nio (NH4+ &#8211; n\u00e3o absorv\u00edvel) e tem efeito laxativo (acelera o tr\u00e2nsito).<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Antibi\u00f3ticos n\u00e3o absorv\u00edveis:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Rifaximina:<\/strong> Melhor perfil de seguran\u00e7a.<\/li>\n\n\n\n<li><em>Alternativas:<\/em> Neomicina (risco de ototoxicidade\/nefrotoxicidade) ou Metronidazol (risco de neuropatia).<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.grupomedcof.com.br\/cofletters\/\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"366\" src=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-1024x366.png\" alt=\"\" class=\"wp-image-29290\" srcset=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-1024x366.png 1024w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-300x107.png 300w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-768x275.png 768w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-1536x549.png 1536w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-2048x732.png 2048w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-1174x420.png 1174w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-150x54.png 150w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-696x249.png 696w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-1068x382.png 1068w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/Capa-Eventos-MedCof-Plus-14-4-1920x687.png 1920w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-sindrome-hepatorrenal-shr\"><span class=\"ez-toc-section\" id=\"Sindrome_Hepatorrenal_SHR\"><\/span><strong><strong>S\u00edndrome Hepatorrenal (SHR)<\/strong><\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Muitas vezes, a EH vem acompanhada de disfun\u00e7\u00e3o renal. A SHR \u00e9 um diagn\u00f3stico de exclus\u00e3o em cirr\u00f3ticos com ascite.<\/p>\n\n\n\n<p>A S\u00edndrome Hepatorrenal \u00e9 uma insufici\u00eancia renal funcional causada por <strong>vasodilata\u00e7\u00e3o espl\u00e2ncnica<\/strong> severa, que leva a uma hipoperfus\u00e3o renal extrema (o rim est\u00e1 estruturalmente &#8220;s\u00e3o&#8221;, mas n\u00e3o recebe sangue suficiente devido ao sequestro espl\u00e2ncnico).<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"592\" height=\"398\" src=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-13.png\" alt=\"\" class=\"wp-image-41168\" srcset=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-13.png 592w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-13-300x202.png 300w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-13-150x101.png 150w\" sizes=\"auto, (max-width: 592px) 100vw, 592px\" \/><figcaption class=\"wp-element-caption\">Fonte: Acervo de aulas do Grupo MedCof.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-como-diagnosticar-criterios-ica-aki\"><span class=\"ez-toc-section\" id=\"Como_diagnosticar_Criterios_ICA-AKI\"><\/span><strong>Como diagnosticar? (Crit\u00e9rios ICA-AKI)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Voc\u00ea est\u00e1 diante de uma Les\u00e3o Renal Aguda (LRA) em um cirr\u00f3tico. O passo a passo \u00e9:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Retirar diur\u00e9ticos e drogas nefrot\u00f3xicas.<\/li>\n\n\n\n<li>Descartar choque e infec\u00e7\u00e3o ativa.<\/li>\n\n\n\n<li><strong>O Teste da Albumina:<\/strong> Administrar Albumina <strong>1 g\/kg\/dia por 2 dias<\/strong>.\n<ul class=\"wp-block-list\">\n<li><em>Melhorou a Creatinina?<\/em> Era LRA pr\u00e9-renal (desidrata\u00e7\u00e3o).<\/li>\n\n\n\n<li><em>N\u00e3o melhorou?<\/em> Prov\u00e1vel <strong>S\u00edndrome Hepatorrenal (HRS-AKI)<\/strong>.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Confirma\u00e7\u00e3o: O USG renal deve ser normal e n\u00e3o pode haver protein\u00faria ou hemat\u00faria significativas.<\/li>\n<\/ol>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"277\" src=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14-1024x277.png\" alt=\"\" class=\"wp-image-41169\" srcset=\"https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14-1024x277.png 1024w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14-300x81.png 300w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14-768x207.png 768w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14-150x41.png 150w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14-696x188.png 696w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14-1068x288.png 1068w, https:\/\/www.grupomedcof.com.br\/blog\/wp-content\/uploads\/2024\/08\/image-14.png 1322w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">Fonte: Acervo de aulas do Grupo MedCof.\u00a0<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-tratamento-da-sindrome-hepatorrenal\"><span class=\"ez-toc-section\" id=\"Tratamento_da_Sindrome_Hepatorrenal\"><\/span><strong>Tratamento da S\u00edndrome Hepatorrenal<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>O objetivo \u00e9 promover vasoconstri\u00e7\u00e3o espl\u00eanica para jogar o sangue de volta para a circula\u00e7\u00e3o efetiva e para o rim.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Droga de Escolha:<\/strong> <strong>Terlipressina<\/strong> associada \u00e0 <strong>Albumina<\/strong>.<\/li>\n\n\n\n<li><em>Alternativa:<\/em> Noradrenalina (se Terlipressina indispon\u00edvel).<\/li>\n\n\n\n<li><em>Contraindica\u00e7\u00e3o da Terlipressina:<\/em> Doen\u00e7a coronariana ou AVC isqu\u00eamico.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"o-m\u00e9todo-que-te-aprova\"><span class=\"ez-toc-section\" id=\"O_metodo_que_te_aprova\"><\/span><strong>O m\u00e9todo que te aprova!<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Quer alcan\u00e7ar a aprova\u00e7\u00e3o nas provas de resid\u00eancia m\u00e9dica? Ent\u00e3o seja um&nbsp;<a href=\"https:\/\/www.grupomedcof.com.br\/home\/\" target=\"_blank\" rel=\"noreferrer noopener\">MedCoffer<\/a>! Aqui te ajudaremos na busca da aprova\u00e7\u00e3o com conte\u00fados de qualidade e uma&nbsp;<a href=\"https:\/\/www.grupomedcof.com.br\/blog\/presenca-da-medcof-nas-aprovacoes-em-residencia-medica-no-brasil\/\" target=\"_blank\" rel=\"noreferrer noopener\">metodologia que j\u00e1 aprovou mais de 10 mil residentes no pa\u00eds!&nbsp;<\/a>Por fim, acesse o nosso<a href=\"https:\/\/www.youtube.com\/@GrupoMedcof\/featured\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;<strong>canal do youtube&nbsp;<\/strong><\/a>para ver o nosso material.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<div class=\"youtube-embed\" data-video_id=\"YbIDVh6R7b0\"><iframe loading=\"lazy\" title=\"Tudo o que voc\u00ea precisa saber sobre Ascite e Peritonite Bacteriana Espont\u00e2nea. Com Dr. Rafael Ba...\" width=\"696\" height=\"392\" src=\"https:\/\/www.youtube.com\/embed\/YbIDVh6R7b0?feature=oembed&#038;enablejsapi=1\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<\/div><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Entenda sobre a Encefalopatia Hep\u00e1tica e S\u00edndrome Hepatorrenal, decorrentes de fal\u00eancia hep\u00e1tica e dos shunts portossist\u00eamicos.<\/p>\n","protected":false},"author":21,"featured_media":29327,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[115,69],"tags":[1938],"ppma_author":[3617],"class_list":{"0":"post-29324","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-clinica-medica","8":"category-gastroenterologia","9":"tag-cirrose"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.3 (Yoast SEO v27.5) - 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