Baveno VIII.pdf
8.8 MB
Baveno VIII – Advancing Consensus in Portal Hypertension 2026
Global ACLF Management 2026.pdf
1.5 MB
A global consensus on the critical care management of acute‑on‑chronic liver failure patients: the APASL ACLF Beijing Position Paper
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file.pdf
3.3 MB
ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease 2026
file.pdf
743.4 KB
Efficacy of Overtube in Preventing Aspiration Pneumonia During Esophageal Endoscopic Submucosal Dissection
Hyponatremia in cirrhosis
1. Hyponatremia is common in patients with cirrhosis and ascites, and stems from splanchnic vasodilation, which lowers effective arterial blood volume and triggers the RAAS system, sympathetic nervous system, and non-osmotic release of ADH.
2. Assessment of hyponatremia should include chronicity, symptoms, and volume status.In patients with cirrhosis, evaluate for common causes of hypovolemia such as diuretic use, lactulose use, or recent large volume paracentesis.
3. Patients with cirrhosis are considered high risk for osmotic demyelination syndrome, and comorbid alcohol use disorder, potassium depletion, and malnutrition convey additional risk. Goal correction is reduced from 4-8 mEq/L per day to 4-6 mEq/L per day.
4. Hyponatremia is a poor
prognostic marker in cirrhosis and has been incorporated into the MELD-Na score. Hyponatremia is associated with higher rates of complications such as hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome.
1. Hyponatremia is common in patients with cirrhosis and ascites, and stems from splanchnic vasodilation, which lowers effective arterial blood volume and triggers the RAAS system, sympathetic nervous system, and non-osmotic release of ADH.
2. Assessment of hyponatremia should include chronicity, symptoms, and volume status.In patients with cirrhosis, evaluate for common causes of hypovolemia such as diuretic use, lactulose use, or recent large volume paracentesis.
3. Patients with cirrhosis are considered high risk for osmotic demyelination syndrome, and comorbid alcohol use disorder, potassium depletion, and malnutrition convey additional risk. Goal correction is reduced from 4-8 mEq/L per day to 4-6 mEq/L per day.
4. Hyponatremia is a poor
prognostic marker in cirrhosis and has been incorporated into the MELD-Na score. Hyponatremia is associated with higher rates of complications such as hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome.
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PIIS1542356526003587.pdf
4 MB
AGA Clinical Practice Update on Management of Clostridioides difficile Infection in Adults: Expert Review 2026
CGH 2026
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