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  1. README.md +7 -5
  2. index.html +1252 -19
  3. prompts.txt +2 -0
README.md CHANGED
@@ -1,10 +1,12 @@
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  ---
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- title: Teste
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- emoji: 🏢
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- colorFrom: green
5
- colorTo: yellow
6
  sdk: static
7
  pinned: false
 
 
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  ---
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- Check out the configuration reference at https://huggingface.co/docs/hub/spaces-config-reference
 
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  ---
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+ title: teste
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+ emoji: 🐳
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+ colorFrom: pink
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+ colorTo: blue
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  sdk: static
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  pinned: false
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+ tags:
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+ - deepsite
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  ---
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+ Check out the configuration reference at https://huggingface.co/docs/hub/spaces-config-reference
index.html CHANGED
@@ -1,19 +1,1252 @@
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- <!doctype html>
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- <html>
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- <head>
4
- <meta charset="utf-8" />
5
- <meta name="viewport" content="width=device-width" />
6
- <title>My static Space</title>
7
- <link rel="stylesheet" href="style.css" />
8
- </head>
9
- <body>
10
- <div class="card">
11
- <h1>Welcome to your static Space!</h1>
12
- <p>You can modify this app directly by editing <i>index.html</i> in the Files and versions tab.</p>
13
- <p>
14
- Also don't forget to check the
15
- <a href="https://huggingface.co/docs/hub/spaces" target="_blank">Spaces documentation</a>.
16
- </p>
17
- </div>
18
- </body>
19
- </html>
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1
+ <!DOCTYPE html>
2
+ <html lang="pt-BR">
3
+ <head>
4
+ <meta charset="UTF-8">
5
+ <meta name="viewport" content="width=device-width, initial-scale=1.0">
6
+ <title>Protocolo Tx Hepático - HUWC-HSC | Anestesiologia</title>
7
+ <script src="https://cdn.tailwindcss.com"></script>
8
+ <link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/font-awesome/6.4.0/css/all.min.css">
9
+ <style>
10
+ .slide {
11
+ display: none;
12
+ padding: 2rem;
13
+ height: 100vh;
14
+ overflow-y: auto;
15
+ }
16
+ .active-slide {
17
+ display: block;
18
+ }
19
+ .progress-bar {
20
+ height: 5px;
21
+ background: linear-gradient(90deg, #3b82f6 0%, #10b981 100%);
22
+ transition: width 0.3s ease;
23
+ }
24
+ .chart-container {
25
+ position: relative;
26
+ height: 300px;
27
+ width: 100%;
28
+ }
29
+ .flowchart {
30
+ display: flex;
31
+ flex-direction: column;
32
+ align-items: center;
33
+ }
34
+ .flowchart-step {
35
+ position: relative;
36
+ padding: 1rem;
37
+ margin: 0.5rem;
38
+ border-radius: 0.5rem;
39
+ width: 80%;
40
+ text-align: center;
41
+ box-shadow: 0 4px 6px -1px rgba(0, 0, 0, 0.1);
42
+ }
43
+ .flowchart-arrow {
44
+ width: 0;
45
+ height: 0;
46
+ border-left: 15px solid transparent;
47
+ border-right: 15px solid transparent;
48
+ border-top: 15px solid #3b82f6;
49
+ }
50
+ .highlight {
51
+ background-color: #fef3c7;
52
+ padding: 0.2rem 0.5rem;
53
+ border-radius: 0.25rem;
54
+ }
55
+ </style>
56
+ </head>
57
+ <body class="bg-gray-100 font-sans">
58
+ <!-- Progress Bar -->
59
+ <div class="progress-bar fixed top-0 left-0" style="width: 0%"></div>
60
+
61
+ <!-- Slides Container -->
62
+ <div class="slides-container relative">
63
+ <!-- Slide 1: Title -->
64
+ <div class="slide active-slide bg-gradient-to-br from-blue-900 to-blue-700 text-white">
65
+ <div class="flex flex-col items-center justify-center h-full">
66
+ <img src="https://img.icons8.com/color/96/000000/hospital.png" alt="Hospital Icon" class="mb-6">
67
+ <h1 class="text-4xl md:text-5xl font-bold mb-4 text-center">Protocolo de Transplante Hepático</h1>
68
+ <h2 class="text-2xl md:text-3xl font-semibold mb-8 text-center">HUWC-HSC | Serviço de Anestesiologia</h2>
69
+ <div class="bg-white text-blue-900 px-6 py-3 rounded-full font-medium">
70
+ Capacitação para Médicos Residentes
71
+ </div>
72
+ <p class="mt-8 text-blue-200">Hospital São Domingos | Departamento de Anestesiologia</p>
73
+ </div>
74
+ </div>
75
+
76
+ <!-- Slide 2: Objetivos -->
77
+ <div class="slide bg-white">
78
+ <div class="container mx-auto px-4 py-8">
79
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
80
+ <i class="fas fa-bullseye mr-4 text-blue-600"></i> Objetivos do Protocolo
81
+ </h2>
82
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
83
+ <div class="bg-blue-50 p-6 rounded-lg border-l-4 border-blue-500">
84
+ <h3 class="text-xl font-semibold text-blue-700 mb-3">Objetivo Principal</h3>
85
+ <p class="text-gray-700">Padronizar a abordagem anestésica para transplantes hepáticos no HUWC-HSC, garantindo segurança e eficácia.</p>
86
+ </div>
87
+ <div class="bg-green-50 p-6 rounded-lg border-l-4 border-green-500">
88
+ <h3 class="text-xl font-semibold text-green-700 mb-3">Objetivos Específicos</h3>
89
+ <ul class="list-disc pl-5 text-gray-700 space-y-2">
90
+ <li>Otimizar o manejo perioperatório</li>
91
+ <li>Reduzir complicações intra e pós-operatórias</li>
92
+ <li>Uniformizar condutas entre a equipe</li>
93
+ <li>Melhorar desfechos clínicos</li>
94
+ </ul>
95
+ </div>
96
+ </div>
97
+ <div class="mt-8 bg-yellow-50 p-6 rounded-lg border-l-4 border-yellow-500">
98
+ <h3 class="text-xl font-semibold text-yellow-700 mb-3">Público-Alvo</h3>
99
+ <p class="text-gray-700">Médicos residentes do servi��o de anestesiologia do Hospital São Domingos envolvidos no cuidado de pacientes submetidos a transplante hepático.</p>
100
+ </div>
101
+ </div>
102
+ </div>
103
+
104
+ <!-- Slide 3: Epidemiologia -->
105
+ <div class="slide bg-gray-50">
106
+ <div class="container mx-auto px-4 py-8">
107
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
108
+ <i class="fas fa-chart-line mr-4 text-blue-600"></i> Epidemiologia do Transplante Hepático
109
+ </h2>
110
+
111
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8">
112
+ <div>
113
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Dados Globais</h3>
114
+ <div class="bg-white p-4 rounded-lg shadow">
115
+ <div class="chart-container">
116
+ <canvas id="epidemiologyChart"></canvas>
117
+ </div>
118
+ <p class="text-sm text-gray-600 mt-2">Fonte: Global Observatory on Donation and Transplantation (2022)</p>
119
+ </div>
120
+ </div>
121
+
122
+ <div>
123
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Principais Indicações</h3>
124
+ <div class="bg-white p-4 rounded-lg shadow">
125
+ <div class="chart-container">
126
+ <canvas id="indicationsChart"></canvas>
127
+ </div>
128
+ </div>
129
+ </div>
130
+ </div>
131
+
132
+ <div class="mt-8 bg-white p-6 rounded-lg shadow">
133
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Dados Nacionais</h3>
134
+ <div class="overflow-x-auto">
135
+ <table class="min-w-full bg-white">
136
+ <thead class="bg-blue-800 text-white">
137
+ <tr>
138
+ <th class="py-3 px-4 text-left">Ano</th>
139
+ <th class="py-3 px-4 text-left">Transplantes</th>
140
+ <th class="py-3 px-4 text-left">Lista de Espera</th>
141
+ <th class="py-3 px-4 text-left">Mortalidade</th>
142
+ </tr>
143
+ </thead>
144
+ <tbody class="text-gray-700">
145
+ <tr class="border-b border-gray-200">
146
+ <td class="py-3 px-4">2020</td>
147
+ <td class="py-3 px-4">1,850</td>
148
+ <td class="py-3 px-4">2,300</td>
149
+ <td class="py-3 px-4">8.2%</td>
150
+ </tr>
151
+ <tr class="border-b border-gray-200">
152
+ <td class="py-3 px-4">2021</td>
153
+ <td class="py-3 px-4">1,920</td>
154
+ <td class="py-3 px-4">2,450</td>
155
+ <td class="py-3 px-4">7.8%</td>
156
+ </tr>
157
+ <tr>
158
+ <td class="py-3 px-4">2022</td>
159
+ <td class="py-3 px-4">2,050</td>
160
+ <td class="py-3 px-4">2,600</td>
161
+ <td class="py-3 px-4">7.5%</td>
162
+ </tr>
163
+ </tbody>
164
+ </table>
165
+ </div>
166
+ <p class="text-sm text-gray-600 mt-4">Fonte: Associação Brasileira de Transplante de Órgãos (ABTO)</p>
167
+ </div>
168
+ </div>
169
+ </div>
170
+
171
+ <!-- Slide 4: Indicações -->
172
+ <div class="slide bg-gradient-to-br from-blue-50 to-white">
173
+ <div class="container mx-auto px-4 py-8">
174
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
175
+ <i class="fas fa-list-check mr-4 text-blue-600"></i> Indicações para Transplante Hepático
176
+ </h2>
177
+
178
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8">
179
+ <div>
180
+ <div class="bg-white p-6 rounded-lg shadow-lg">
181
+ <h3 class="text-xl font-semibold text-blue-700 mb-4 border-b pb-2">Indicações Absolutas</h3>
182
+ <ul class="space-y-3">
183
+ <li class="flex items-start">
184
+ <i class="fas fa-check-circle text-green-500 mt-1 mr-3"></i>
185
+ <span>Falência hepática aguda</span>
186
+ </li>
187
+ <li class="flex items-start">
188
+ <i class="fas fa-check-circle text-green-500 mt-1 mr-3"></i>
189
+ <span>Cirrose descompensada (Child-Pugh ≥7)</span>
190
+ </li>
191
+ <li class="flex items-start">
192
+ <i class="fas fa-check-circle text-green-500 mt-1 mr-3"></i>
193
+ <span>Carcinoma hepatocelular dentro dos critérios de Milão</span>
194
+ </li>
195
+ <li class="flex items-start">
196
+ <i class="fas fa-check-circle text-green-500 mt-1 mr-3"></i>
197
+ <span>Doenças metabólicas com manifestação hepática</span>
198
+ </li>
199
+ </ul>
200
+ </div>
201
+ </div>
202
+
203
+ <div>
204
+ <div class="bg-white p-6 rounded-lg shadow-lg">
205
+ <h3 class="text-xl font-semibold text-blue-700 mb-4 border-b pb-2">Indicações Relativas</h3>
206
+ <ul class="space-y-3">
207
+ <li class="flex items-start">
208
+ <i class="fas fa-exclamation-circle text-yellow-500 mt-1 mr-3"></i>
209
+ <span>Hipertensão portal com sangramento recorrente</span>
210
+ </li>
211
+ <li class="flex items-start">
212
+ <i class="fas fa-exclamation-circle text-yellow-500 mt-1 mr-3"></i>
213
+ <span>Encefalopatia hepática refratária</span>
214
+ </li>
215
+ <li class="flex items-start">
216
+ <i class="fas fa-exclamation-circle text-yellow-500 mt-1 mr-3"></i>
217
+ <span>Síndrome hepatopulmonar</span>
218
+ </li>
219
+ <li class="flex items-start">
220
+ <i class="fas fa-exclamation-circle text-yellow-500 mt-1 mr-3"></i>
221
+ <span>Qualidade de vida inaceitável</span>
222
+ </li>
223
+ </ul>
224
+ </div>
225
+ </div>
226
+ </div>
227
+
228
+ <div class="mt-8 bg-white p-6 rounded-lg shadow-lg">
229
+ <h3 class="text-xl font-semibold text-blue-700 mb-4 border-b pb-2">Critérios de Exclusão</h3>
230
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-4">
231
+ <ul class="space-y-2">
232
+ <li class="flex items-start">
233
+ <i class="fas fa-times-circle text-red-500 mt-1 mr-3"></i>
234
+ <span>Infecção ativa não controlada</span>
235
+ </li>
236
+ <li class="flex items-start">
237
+ <i class="fas fa-times-circle text-red-500 mt-1 mr-3"></i>
238
+ <span>Neoplasia extra-hepática</span>
239
+ </li>
240
+ </ul>
241
+ <ul class="space-y-2">
242
+ <li class="flex items-start">
243
+ <i class="fas fa-times-circle text-red-500 mt-1 mr-3"></i>
244
+ <span>Doença cardiopulmonar grave irreversível</span>
245
+ </li>
246
+ <li class="flex items-start">
247
+ <i class="fas fa-times-circle text-red-500 mt-1 mr-3"></i>
248
+ <span>Dependência de álcool/drogas ativa</span>
249
+ </li>
250
+ </ul>
251
+ </div>
252
+ </div>
253
+ </div>
254
+ </div>
255
+
256
+ <!-- Slide 5: Avaliação Pré-Operatória -->
257
+ <div class="slide bg-white">
258
+ <div class="container mx-auto px-4 py-8">
259
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
260
+ <i class="fas fa-user-md mr-4 text-blue-600"></i> Avaliação Pré-Operatória
261
+ </h2>
262
+
263
+ <div class="flowchart mb-8">
264
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
265
+ <i class="fas fa-history mr-2"></i> História Clínica Completa
266
+ </div>
267
+ <div class="flowchart-arrow"></div>
268
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
269
+ <i class="fas fa-procedures mr-2"></i> Exame Físico Detalhado
270
+ </div>
271
+ <div class="flowchart-arrow"></div>
272
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
273
+ <i class="fas fa-vial mr-2"></i> Exames Laboratoriais
274
+ </div>
275
+ <div class="flowchart-arrow"></div>
276
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
277
+ <i class="fas fa-heartbeat mr-2"></i> Avaliação Cardiopulmonar
278
+ </div>
279
+ <div class="flowchart-arrow"></div>
280
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
281
+ <i class="fas fa-brain mr-2"></i> Avaliação Neurológica
282
+ </div>
283
+ </div>
284
+
285
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
286
+ <div class="bg-blue-50 p-4 rounded-lg">
287
+ <h3 class="text-xl font-semibold text-blue-700 mb-3">Exames Essenciais</h3>
288
+ <ul class="list-disc pl-5 space-y-2 text-gray-700">
289
+ <li>Hemograma completo</li>
290
+ <li>Coagulograma (TAP, TTPA, fibrinogênio)</li>
291
+ <li>Função renal (ureia, creatinina)</li>
292
+ <li>Eletrólitos</li>
293
+ <li>Gasometria arterial</li>
294
+ <li>Testes de função hepática</li>
295
+ <li>Ecocardiograma</li>
296
+ </ul>
297
+ </div>
298
+
299
+ <div class="bg-green-50 p-4 rounded-lg">
300
+ <h3 class="text-xl font-semibold text-green-700 mb-3">Escalas de Avaliação</h3>
301
+ <div class="space-y-4">
302
+ <div>
303
+ <h4 class="font-medium text-green-800">Child-Pugh</h4>
304
+ <div class="bg-white p-2 rounded mt-1">
305
+ <div class="flex justify-between text-sm">
306
+ <span>A (5-6)</span>
307
+ <span>B (7-9)</span>
308
+ <span>C (10-15)</span>
309
+ </div>
310
+ <div class="w-full bg-gray-200 rounded-full h-2.5 mt-1">
311
+ <div class="bg-green-600 h-2.5 rounded-full" style="width: 30%"></div>
312
+ </div>
313
+ </div>
314
+ </div>
315
+ <div>
316
+ <h4 class="font-medium text-green-800">MELD</h4>
317
+ <div class="bg-white p-2 rounded mt-1">
318
+ <div class="flex justify-between text-sm">
319
+ <span><15</span>
320
+ <span>15-25</span>
321
+ <span>>25</span>
322
+ </div>
323
+ <div class="w-full bg-gray-200 rounded-full h-2.5 mt-1">
324
+ <div class="bg-green-600 h-2.5 rounded-full" style="width: 60%"></div>
325
+ </div>
326
+ </div>
327
+ </div>
328
+ </div>
329
+ </div>
330
+ </div>
331
+ </div>
332
+ </div>
333
+
334
+ <!-- Slide 6: Preparo Pré-Operatório -->
335
+ <div class="slide bg-gray-50">
336
+ <div class="container mx-auto px-4 py-8">
337
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
338
+ <i class="fas fa-clipboard-check mr-4 text-blue-600"></i> Preparo Pré-Operatório
339
+ </h2>
340
+
341
+ <div class="grid grid-cols-1 md:grid-cols-3 gap-4 mb-8">
342
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-blue-500">
343
+ <div class="text-blue-600 mb-2">
344
+ <i class="fas fa-prescription-bottle-alt text-2xl"></i>
345
+ </div>
346
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Correção de Coagulopatia</h3>
347
+ <ul class="text-sm text-gray-700 space-y-1">
348
+ <li>Vitamina K (10mg EV)</li>
349
+ <li>Plasma fresco congelado</li>
350
+ <li>Crioprecipitado se fibrinogênio <100mg/dL</li>
351
+ <li>Plaquetas se <50.000/mm³</li>
352
+ </ul>
353
+ </div>
354
+
355
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-green-500">
356
+ <div class="text-green-600 mb-2">
357
+ <i class="fas fa-tint text-2xl"></i>
358
+ </div>
359
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Manejo de Ascite</h3>
360
+ <ul class="text-sm text-gray-700 space-y-1">
361
+ <li>Paracentese pré-operatória se volumosa</li>
362
+ <li>Albumina 20% (8g/L removido)</li>
363
+ <li>Restrição hídrica cuidadosa</li>
364
+ </ul>
365
+ </div>
366
+
367
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-purple-500">
368
+ <div class="text-purple-600 mb-2">
369
+ <i class="fas fa-brain text-2xl"></i>
370
+ </div>
371
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Encefalopatia Hepática</h3>
372
+ <ul class="text-sm text-gray-700 space-y-1">
373
+ <li>Lactulose (30ml 6/6h)</li>
374
+ <li>Rifaximina (550mg 12/12h)</li>
375
+ <li>Evitar sedativos</li>
376
+ </ul>
377
+ </div>
378
+ </div>
379
+
380
+ <div class="bg-white p-6 rounded-lg shadow">
381
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Preparo Anestésico</h3>
382
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
383
+ <div>
384
+ <h4 class="font-medium text-blue-700 mb-2">Jejum</h4>
385
+ <ul class="list-disc pl-5 text-gray-700 space-y-1">
386
+ <li>6h para sólidos</li>
387
+ <li>2h para líquidos claros</li>
388
+ <li>Considerar risco de aspiração</li>
389
+ </ul>
390
+ </div>
391
+ <div>
392
+ <h4 class="font-medium text-blue-700 mb-2">Pré-Medicação</h4>
393
+ <ul class="list-disc pl-5 text-gray-700 space-y-1">
394
+ <li>Ranitidina 50mg EV</li>
395
+ <li>Metoclopramida 10mg EV</li>
396
+ <li>Sedativos com cautela</li>
397
+ </ul>
398
+ </div>
399
+ </div>
400
+ </div>
401
+ </div>
402
+ </div>
403
+
404
+ <!-- Slide 7: Monitorização Intraoperatória -->
405
+ <div class="slide bg-gradient-to-br from-blue-900 to-blue-700 text-white">
406
+ <div class="container mx-auto px-4 py-8">
407
+ <h2 class="text-3xl font-bold mb-6 flex items-center">
408
+ <i class="fas fa-heartbeat mr-4"></i> Monitorização Intraoperatória
409
+ </h2>
410
+
411
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8">
412
+ <div>
413
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
414
+ <h3 class="text-xl font-semibold mb-4">Monitorização Básica</h3>
415
+ <ul class="space-y-3">
416
+ <li class="flex items-start">
417
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
418
+ <span>ECG contínuo (DII e V5)</span>
419
+ </li>
420
+ <li class="flex items-start">
421
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
422
+ <span>Pressão arterial invasiva</span>
423
+ </li>
424
+ <li class="flex items-start">
425
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
426
+ <span>Plethismografia (SpO₂)</span>
427
+ </li>
428
+ <li class="flex items-start">
429
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
430
+ <span>Capnografia</span>
431
+ </li>
432
+ <li class="flex items-start">
433
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
434
+ <span>Temperatura (nasofaríngea/vesical)</span>
435
+ </li>
436
+ </ul>
437
+ </div>
438
+ </div>
439
+
440
+ <div>
441
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
442
+ <h3 class="text-xl font-semibold mb-4">Monitorização Avançada</h3>
443
+ <ul class="space-y-3">
444
+ <li class="flex items-start">
445
+ <i class="fas fa-star text-yellow-300 mt-1 mr-3"></i>
446
+ <span>Cateter venoso central (CVC)</span>
447
+ </li>
448
+ <li class="flex items-start">
449
+ <i class="fas fa-star text-yellow-300 mt-1 mr-3"></i>
450
+ <span>Cateter de artéria pulmonar (opcional)</span>
451
+ </li>
452
+ <li class="flex items-start">
453
+ <i class="fas fa-star text-yellow-300 mt-1 mr-3"></i>
454
+ <span>Ecocardiografia transesofágica (ETE)</span>
455
+ </li>
456
+ <li class="flex items-start">
457
+ <i class="fas fa-star text-yellow-300 mt-1 mr-3"></i>
458
+ <span>Monitorização da coagulação (TEG/ROTEM)</span>
459
+ </li>
460
+ <li class="flex items-start">
461
+ <i class="fas fa-star text-yellow-300 mt-1 mr-3"></i>
462
+ <span>BIS para profundidade anestésica</span>
463
+ </li>
464
+ </ul>
465
+ </div>
466
+ </div>
467
+ </div>
468
+
469
+ <div class="mt-8 bg-blue-800 bg-opacity-50 p-6 rounded-lg">
470
+ <h3 class="text-xl font-semibold mb-4">Parâmetros Alvo</h3>
471
+ <div class="overflow-x-auto">
472
+ <table class="min-w-full bg-blue-900 bg-opacity-50">
473
+ <thead>
474
+ <tr class="text-blue-200">
475
+ <th class="py-3 px-4 text-left">Parâmetro</th>
476
+ <th class="py-3 px-4 text-left">Valor Alvo</th>
477
+ </tr>
478
+ </thead>
479
+ <tbody class="text-white">
480
+ <tr class="border-b border-blue-700">
481
+ <td class="py-3 px-4">PAM</td>
482
+ <td class="py-3 px-4">>65 mmHg</td>
483
+ </tr>
484
+ <tr class="border-b border-blue-700">
485
+ <td class="py-3 px-4">PVC</td>
486
+ <td class="py-3 px-4">8-12 mmHg</td>
487
+ </tr>
488
+ <tr class="border-b border-blue-700">
489
+ <td class="py-3 px-4">SatO₂</td>
490
+ <td class="py-3 px-4">>95%</td>
491
+ </tr>
492
+ <tr class="border-b border-blue-700">
493
+ <td class="py-3 px-4">Débito urinário</td>
494
+ <td class="py-3 px-4">>0.5 mL/kg/h</td>
495
+ </tr>
496
+ <tr>
497
+ <td class="py-3 px-4">BIS</td>
498
+ <td class="py-3 px-4">40-60</td>
499
+ </tr>
500
+ </tbody>
501
+ </table>
502
+ </div>
503
+ </div>
504
+ </div>
505
+ </div>
506
+
507
+ <!-- Slide 8: Indução Anestésica -->
508
+ <div class="slide bg-white">
509
+ <div class="container mx-auto px-4 py-8">
510
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
511
+ <i class="fas fa-syringe mr-4 text-blue-600"></i> Indução Anestésica
512
+ </h2>
513
+
514
+ <div class="flowchart mb-8">
515
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
516
+ <i class="fas fa-user-shield mr-2"></i> Pré-oxigenação (100% O₂ por 3-5 min)
517
+ </div>
518
+ <div class="flowchart-arrow"></div>
519
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
520
+ <i class="fas fa-procedures mr-2"></i> Monitorização Básica + Acesso Venoso
521
+ </div>
522
+ <div class="flowchart-arrow"></div>
523
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
524
+ <i class="fas fa-prescription-bottle mr-2"></i> Pré-medicação (Fentanil 1-2μg/kg)
525
+ </div>
526
+ <div class="flowchart-arrow"></div>
527
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
528
+ <i class="fas fa-capsules mr-2"></i> Indução (Propofol 1-2mg/kg ou Etomidato 0.2-0.3mg/kg)
529
+ </div>
530
+ <div class="flowchart-arrow"></div>
531
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
532
+ <i class="fas fa-lungs mr-2"></i> Intubação (Rocurônio 0.6-1mg/kg ou Succinilcolina 1-1.5mg/kg)
533
+ </div>
534
+ </div>
535
+
536
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
537
+ <div class="bg-blue-50 p-4 rounded-lg">
538
+ <h3 class="text-xl font-semibold text-blue-700 mb-3">Considerações Especiais</h3>
539
+ <ul class="list-disc pl-5 space-y-2 text-gray-700">
540
+ <li>Redução de doses em pacientes com encefalopatia</li>
541
+ <li>Cuidado com hipotensão após indução</li>
542
+ <li>Preparar vasopressores (fenilefrina/noradrenalina)</li>
543
+ <li>Evitar hipóxia e hipercapnia</li>
544
+ </ul>
545
+ </div>
546
+
547
+ <div class="bg-green-50 p-4 rounded-lg">
548
+ <h3 class="text-xl font-semibold text-green-700 mb-3">Manejo das Vias Aéreas</h3>
549
+ <ul class="list-disc pl-5 space-y-2 text-gray-700">
550
+ <li>Tubo endotraqueal reforçado (proteção contra mordida)</li>
551
+ <li>Capnografia essencial</li>
552
+ <li>Preparar para via aérea difícil (MELD alto, ascite)</li>
553
+ <li>Posicionamento cuidadoso (risco de sangramento)</li>
554
+ </ul>
555
+ </div>
556
+ </div>
557
+ </div>
558
+ </div>
559
+
560
+ <!-- Slide 9: Manutenção Anestésica -->
561
+ <div class="slide bg-gray-50">
562
+ <div class="container mx-auto px-4 py-8">
563
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
564
+ <i class="fas fa-clock mr-4 text-blue-600"></i> Manutenção Anestésica
565
+ </h2>
566
+
567
+ <div class="grid grid-cols-1 md:grid-cols-3 gap-4 mb-8">
568
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-blue-500">
569
+ <div class="text-blue-600 mb-2">
570
+ <i class="fas fa-cloud-meatball text-2xl"></i>
571
+ </div>
572
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Agentes Inalatórios</h3>
573
+ <ul class="text-sm text-gray-700 space-y-1">
574
+ <li>Isoflurano ou Sevoflurano (0.8-1.2 CAM)</li>
575
+ <li>Evitar Halotano (hepatotoxicidade)</li>
576
+ <li>Monitorar efeitos hemodinâmicos</li>
577
+ </ul>
578
+ </div>
579
+
580
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-purple-500">
581
+ <div class="text-purple-600 mb-2">
582
+ <i class="fas fa-prescription-bottle-alt text-2xl"></i>
583
+ </div>
584
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Opioides</h3>
585
+ <ul class="text-sm text-gray-700 space-y-1">
586
+ <li>Fentanil (1-5μg/kg/h)</li>
587
+ <li>Remifentanil (0.05-0.2μg/kg/min)</li>
588
+ <li>Evitar morfina (metabolismo hepático)</li>
589
+ </ul>
590
+ </div>
591
+
592
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-green-500">
593
+ <div class="text-green-600 mb-2">
594
+ <i class="fas fa-syringe text-2xl"></i>
595
+ </div>
596
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Relaxantes Musculares</h3>
597
+ <ul class="text-sm text-gray-700 space-y-1">
598
+ <li>Rocurônio (0.3-0.6mg/kg/h)</li>
599
+ <li>Cisatracúrio (0.1mg/kg/h)</li>
600
+ <li>Monitorar com TOF</li>
601
+ </ul>
602
+ </div>
603
+ </div>
604
+
605
+ <div class="bg-white p-6 rounded-lg shadow">
606
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Monitorização da Profundidade Anestésica</h3>
607
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
608
+ <div>
609
+ <h4 class="font-medium text-blue-700 mb-2">BIS (Bispectral Index)</h4>
610
+ <ul class="list-disc pl-5 text-gray-700 space-y-1">
611
+ <li>Manter entre 40-60</li>
612
+ <li>Evitar consciência intraoperatória</li>
613
+ <li>Otimizar uso de anestésicos</li>
614
+ </ul>
615
+ </div>
616
+ <div>
617
+ <h4 class="font-medium text-blue-700 mb-2">Parâmetros Clínicos</h4>
618
+ <ul class="list-disc pl-5 text-gray-700 space-y-1">
619
+ <li>Pressão arterial</li>
620
+ <li>Frequência cardíaca</li>
621
+ <li>Resposta autonômica</li>
622
+ <li>Movimento</li>
623
+ </ul>
624
+ </div>
625
+ </div>
626
+ </div>
627
+ </div>
628
+ </div>
629
+
630
+ <!-- Slide 10: Fases Cirúrgicas -->
631
+ <div class="slide bg-gradient-to-br from-blue-900 to-blue-700 text-white">
632
+ <div class="container mx-auto px-4 py-8">
633
+ <h2 class="text-3xl font-bold mb-6 flex items-center">
634
+ <i class="fas fa-procedures mr-4"></i> Fases Cirúrgicas e Desafios Anestésicos
635
+ </h2>
636
+
637
+ <div class="grid grid-cols-1 md:grid-cols-3 gap-4 mb-8">
638
+ <div class="bg-blue-800 bg-opacity-50 p-4 rounded-lg">
639
+ <h3 class="text-lg font-semibold mb-3">Fase 1: Dissecção</h3>
640
+ <ul class="text-sm text-blue-100 space-y-1">
641
+ <li>Hepatectomia do fígado nativo</li>
642
+ <li>Risco de sangramento</li>
643
+ <li>Monitorar coagulação</li>
644
+ <li>Reposição volêmica cuidadosa</li>
645
+ </ul>
646
+ </div>
647
+
648
+ <div class="bg-blue-800 bg-opacity-50 p-4 rounded-lg">
649
+ <h3 class="text-lg font-semibold mb-3">Fase 2: Anepática</h3>
650
+ <ul class="text-sm text-blue-100 space-y-1">
651
+ <li>Clampeamento vascular</li>
652
+ <li>Instabilidade hemodinâmica</li>
653
+ <li>Acidose metabólica</li>
654
+ <li>Hipotermia</li>
655
+ </ul>
656
+ </div>
657
+
658
+ <div class="bg-blue-800 bg-opacity-50 p-4 rounded-lg">
659
+ <h3 class="text-lg font-semibold mb-3">Fase 3: Reperfusão</h3>
660
+ <ul class="text-sm text-blue-100 space-y-1">
661
+ <li>Síndrome pós-reperfusão</li>
662
+ <li>Hipercalemia</li>
663
+ <li>Hipotensão severa</li>
664
+ <li>Arritmias</li>
665
+ </ul>
666
+ </div>
667
+ </div>
668
+
669
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
670
+ <h3 class="text-xl font-semibold mb-4">Manejo por Fase</h3>
671
+ <div class="overflow-x-auto">
672
+ <table class="min-w-full bg-blue-900 bg-opacity-50">
673
+ <thead>
674
+ <tr class="text-blue-200">
675
+ <th class="py-3 px-4 text-left">Fase</th>
676
+ <th class="py-3 px-4 text-left">Desafios</th>
677
+ <th class="py-3 px-4 text-left">Intervenções</th>
678
+ </tr>
679
+ </thead>
680
+ <tbody class="text-white">
681
+ <tr class="border-b border-blue-700">
682
+ <td class="py-3 px-4">Dissecção</td>
683
+ <td class="py-3 px-4">Sangramento, coagulopatia</td>
684
+ <td class="py-3 px-4">Reposição sanguínea, PFC, plaquetas</td>
685
+ </tr>
686
+ <tr class="border-b border-blue-700">
687
+ <td class="py-3 px-4">Anepática</td>
688
+ <td class="py-3 px-4">Hipotensão, acidose</td>
689
+ <td class="py-3 px-4">Vasopressores, bicarbonato</td>
690
+ </tr>
691
+ <tr>
692
+ <td class="py-3 px-4">Reperfusão</td>
693
+ <td class="py-3 px-4">Síndrome pós-reperfusão</td>
694
+ <td class="py-3 px-4">Calcio, vasopressores, antiarrítmicos</td>
695
+ </tr>
696
+ </tbody>
697
+ </table>
698
+ </div>
699
+ </div>
700
+ </div>
701
+ </div>
702
+
703
+ <!-- Slide 11: Monitorização Hemodinâmica -->
704
+ <div class="slide bg-white">
705
+ <div class="container mx-auto px-4 py-8">
706
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
707
+ <i class="fas fa-tachometer-alt mr-4 text-blue-600"></i> Monitorização Hemodinâmica Avançada
708
+ </h2>
709
+
710
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8 mb-8">
711
+ <div>
712
+ <div class="bg-blue-50 p-6 rounded-lg">
713
+ <h3 class="text-xl font-semibold text-blue-700 mb-4">Cateter de Artéria Pulmonar</h3>
714
+ <div class="flex items-center mb-4">
715
+ <img src="https://img.icons8.com/color/96/000000/heart-monitor.png" alt="Monitor" class="mr-4">
716
+ <div>
717
+ <p class="text-gray-700">Mede:</p>
718
+ <ul class="list-disc pl-5 text-gray-700">
719
+ <li>Pressão capilar pulmonar (PCP)</li>
720
+ <li>Débito cardíaco (DC)</li>
721
+ <li>Resistência vascular sistêmica (RVS)</li>
722
+ <li>Saturação venosa mista (SvO₂)</li>
723
+ </ul>
724
+ </div>
725
+ </div>
726
+ </div>
727
+ </div>
728
+
729
+ <div>
730
+ <div class="bg-green-50 p-6 rounded-lg">
731
+ <h3 class="text-xl font-semibold text-green-700 mb-4">Ecocardiografia Transesofágica</h3>
732
+ <div class="flex items-center mb-4">
733
+ <img src="https://img.icons8.com/color/96/000000/echocardiogram.png" alt="Echo" class="mr-4">
734
+ <div>
735
+ <p class="text-gray-700">Avalia:</p>
736
+ <ul class="list-disc pl-5 text-gray-700">
737
+ <li>Função ventricular</li>
738
+ <li>Volume de enchimento</li>
739
+ <li>Anomalias valvares</li>
740
+ <li>Trombos no fluxo venoso</li>
741
+ </ul>
742
+ </div>
743
+ </div>
744
+ </div>
745
+ </div>
746
+ </div>
747
+
748
+ <div class="bg-gray-50 p-6 rounded-lg">
749
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Parâmetros Hemodinâmicos Ideais</h3>
750
+ <div class="overflow-x-auto">
751
+ <table class="min-w-full bg-white">
752
+ <thead class="bg-blue-800 text-white">
753
+ <tr>
754
+ <th class="py-3 px-4 text-left">Parâmetro</th>
755
+ <th class="py-3 px-4 text-left">Valor Alvo</th>
756
+ <th class="py-3 px-4 text-left">Significado</th>
757
+ </tr>
758
+ </thead>
759
+ <tbody class="text-gray-700">
760
+ <tr class="border-b border-gray-200">
761
+ <td class="py-3 px-4">PAM</td>
762
+ <td class="py-3 px-4">>65 mmHg</td>
763
+ <td class="py-3 px-4">Perfusão orgânica adequada</td>
764
+ </tr>
765
+ <tr class="border-b border-gray-200">
766
+ <td class="py-3 px-4">SvO₂</td>
767
+ <td class="py-3 px-4">>70%</td>
768
+ <td class="py-3 px-4">Balanço oferta/consumo O₂</td>
769
+ </tr>
770
+ <tr class="border-b border-gray-200">
771
+ <td class="py-3 px-4">DC</td>
772
+ <td class="py-3 px-4">4-8 L/min</td>
773
+ <td class="py-3 px-4">Débito cardíaco adequado</td>
774
+ </tr>
775
+ <tr>
776
+ <td class="py-3 px-4">RVS</td>
777
+ <td class="py-3 px-4">800-1200 dyn.s/cm⁵</td>
778
+ <td class="py-3 px-4">Resistência vascular adequada</td>
779
+ </tr>
780
+ </tbody>
781
+ </table>
782
+ </div>
783
+ </div>
784
+ </div>
785
+ </div>
786
+
787
+ <!-- Slide 12: Monitorização da Coagulação -->
788
+ <div class="slide bg-gray-50">
789
+ <div class="container mx-auto px-4 py-8">
790
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
791
+ <i class="fas fa-tint mr-4 text-blue-600"></i> Monitorização da Coagulação
792
+ </h2>
793
+
794
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8 mb-8">
795
+ <div>
796
+ <div class="bg-white p-6 rounded-lg shadow">
797
+ <h3 class="text-xl font-semibold text-blue-700 mb-4">Tromboelastografia (TEG)</h3>
798
+ <div class="chart-container">
799
+ <canvas id="tegChart"></canvas>
800
+ </div>
801
+ <ul class="list-disc pl-5 text-gray-700 mt-4 space-y-2">
802
+ <li>Avaliação global da hemostasia</li>
803
+ <li>Tempo de reação (R)</li>
804
+ <li>Tempo de formação do coágulo (K)</li>
805
+ <li>Força máxima do coágulo (MA)</li>
806
+ </ul>
807
+ </div>
808
+ </div>
809
+
810
+ <div>
811
+ <div class="bg-white p-6 rounded-lg shadow">
812
+ <h3 class="text-xl font-semibold text-blue-700 mb-4">ROTEM</h3>
813
+ <div class="chart-container">
814
+ <canvas id="rotemChart"></canvas>
815
+ </div>
816
+ <ul class="list-disc pl-5 text-gray-700 mt-4 space-y-2">
817
+ <li>Similar ao TEG, mas com tecnologia diferente</li>
818
+ <li>CT (tempo de coagulação)</li>
819
+ <li>CFT (tempo de formação do coágulo)</li>
820
+ <li>MCF (força máxima do coágulo)</li>
821
+ </ul>
822
+ </div>
823
+ </div>
824
+ </div>
825
+
826
+ <div class="bg-white p-6 rounded-lg shadow">
827
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Interpretação dos Resultados</h3>
828
+ <div class="overflow-x-auto">
829
+ <table class="min-w-full bg-white">
830
+ <thead class="bg-blue-800 text-white">
831
+ <tr>
832
+ <th class="py-3 px-4 text-left">Parâmetro</th>
833
+ <th class="py-3 px-4 text-left">Valor Normal</th>
834
+ <th class="py-3 px-4 text-left">Alteração</th>
835
+ <th class="py-3 px-4 text-left">Intervenção</th>
836
+ </tr>
837
+ </thead>
838
+ <tbody class="text-gray-700">
839
+ <tr class="border-b border-gray-200">
840
+ <td class="py-3 px-4">R/CT</td>
841
+ <td class="py-3 px-4">5-10 min</td>
842
+ <td class="py-3 px-4">↑ Deficiência fatores</td>
843
+ <td class="py-3 px-4">PFC</td>
844
+ </tr>
845
+ <tr class="border-b border-gray-200">
846
+ <td class="py-3 px-4">K/CFT</td>
847
+ <td class="py-3 px-4">1-3 min</td>
848
+ <td class="py-3 px-4">↑ Deficiência fibrinogênio</td>
849
+ <td class="py-3 px-4">Crioprecipitado</td>
850
+ </tr>
851
+ <tr class="border-b border-gray-200">
852
+ <td class="py-3 px-4">MA/MCF</td>
853
+ <td class="py-3 px-4">50-70 mm</td>
854
+ <td class="py-3 px-4">↓ Disfunção plaquetas</td>
855
+ <td class="py-3 px-4">Plaquetas</td>
856
+ </tr>
857
+ <tr>
858
+ <td class="py-3 px-4">LY30</td>
859
+ <td class="py-3 px-4"><7.5%</td>
860
+ <td class="py-3 px-4">↑ Fibrinólise</td>
861
+ <td class="py-3 px-4">Ácido tranexâmico</td>
862
+ </tr>
863
+ </tbody>
864
+ </table>
865
+ </div>
866
+ </div>
867
+ </div>
868
+ </div>
869
+
870
+ <!-- Slide 13: Manejo Hemodinâmico -->
871
+ <div class="slide bg-gradient-to-br from-blue-900 to-blue-700 text-white">
872
+ <div class="container mx-auto px-4 py-8">
873
+ <h2 class="text-3xl font-bold mb-6 flex items-center">
874
+ <i class="fas fa-heartbeat mr-4"></i> Manejo Hemodinâmico
875
+ </h2>
876
+
877
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8 mb-8">
878
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
879
+ <h3 class="text-xl font-semibold mb-4">Objetivos Hemodinâmicos</h3>
880
+ <ul class="space-y-3">
881
+ <li class="flex items-start">
882
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
883
+ <span>PAM >65 mmHg</span>
884
+ </li>
885
+ <li class="flex items-start">
886
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
887
+ <span>SvO₂ >70%</span>
888
+ </li>
889
+ <li class="flex items-start">
890
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
891
+ <span>Débito urinário >0.5 mL/kg/h</span>
892
+ </li>
893
+ <li class="flex items-start">
894
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
895
+ <span>Lactato <2 mmol/L</span>
896
+ </li>
897
+ </ul>
898
+ </div>
899
+
900
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
901
+ <h3 class="text-xl font-semibold mb-4">Estratégias de Resuscitação</h3>
902
+ <ul class="space-y-3">
903
+ <li class="flex items-start">
904
+ <i class="fas fa-tint text-blue-300 mt-1 mr-3"></i>
905
+ <span>Reposição volêmica guiada</span>
906
+ </li>
907
+ <li class="flex items-start">
908
+ <i class="fas fa-prescription-bottle text-purple-300 mt-1 mr-3"></i>
909
+ <span>Vasopressores (Noradrenalina 0.05-0.3μg/kg/min)</span>
910
+ </li>
911
+ <li class="flex items-start">
912
+ <i class="fas fa-heart text-red-300 mt-1 mr-3"></i>
913
+ <span>Inotrópicos se baixo débito (Dobutamina 2-10μg/kg/min)</span>
914
+ </li>
915
+ <li class="flex items-start">
916
+ <i class="fas fa-vial text-green-300 mt-1 mr-3"></i>
917
+ <span>Correção de distúrbios metabólicos</span>
918
+ </li>
919
+ </ul>
920
+ </div>
921
+ </div>
922
+
923
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
924
+ <h3 class="text-xl font-semibold mb-4">Algoritmo de Manejo Hemodinâmico</h3>
925
+ <div class="flowchart">
926
+ <div class="flowchart-step bg-blue-700 text-white font-semibold">
927
+ <i class="fas fa-question-circle mr-2"></i> Hipotensão?
928
+ </div>
929
+ <div class="flowchart-arrow"></div>
930
+ <div class="flowchart-step bg-blue-700 text-white font-semibold">
931
+ <i class="fas fa-tint mr-2"></i> Avaliar volume (PVC, ETE)
932
+ </div>
933
+ <div class="flowchart-arrow"></div>
934
+ <div class="flowchart-step bg-blue-700 text-white font-semibold">
935
+ <i class="fas fa-vial mr-2"></i> Reposição volêmica (cristaloides/coloides)
936
+ </div>
937
+ <div class="flowchart-arrow"></div>
938
+ <div class="flowchart-step bg-blue-700 text-white font-semibold">
939
+ <i class="fas fa-prescription-bottle mr-2"></i> Vasopressores (Noradrenalina)
940
+ </div>
941
+ <div class="flowchart-arrow"></div>
942
+ <div class="flowchart-step bg-blue-700 text-white font-semibold">
943
+ <i class="fas fa-heart mr-2"></i> Inotrópicos se baixo débito (Dobutamina)
944
+ </div>
945
+ </div>
946
+ </div>
947
+ </div>
948
+ </div>
949
+
950
+ <!-- Slide 14: Reposição Volêmica -->
951
+ <div class="slide bg-white">
952
+ <div class="container mx-auto px-4 py-8">
953
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
954
+ <i class="fas fa-tint mr-4 text-blue-600"></i> Reposição Volêmica e Hemoderivados
955
+ </h2>
956
+
957
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-6 mb-8">
958
+ <div class="bg-blue-50 p-6 rounded-lg">
959
+ <h3 class="text-xl font-semibold text-blue-700 mb-4">Cristaloides</h3>
960
+ <ul class="list-disc pl-5 text-gray-700 space-y-2">
961
+ <li>Ringer lactato (preferencial)</li>
962
+ <li>Solução fisiológica 0.9% (risco de acidose hiperclorêmica)</li>
963
+ <li>Evitar sobrecarga (avaliar PVC, ETE)</li>
964
+ <li>Balanceados (Plasmalyte) podem ser opção</li>
965
+ </ul>
966
+ </div>
967
+
968
+ <div class="bg-green-50 p-6 rounded-lg">
969
+ <h3 class="text-xl font-semibold text-green-700 mb-4">Coloides</h3>
970
+ <ul class="list-disc pl-5 text-gray-700 space-y-2">
971
+ <li>Albumina 5% (20-25% em ascite refratária)</li>
972
+ <li>Hidroxietilamido (controvérsias em doença hepática)</li>
973
+ <li>Gelatinas (risco de coagulopatia)</li>
974
+ <li>Indicados em hipoalbuminemia grave</li>
975
+ </ul>
976
+ </div>
977
+ </div>
978
+
979
+ <div class="bg-white p-6 rounded-lg shadow">
980
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Transfusão de Hemoderivados</h3>
981
+ <div class="overflow-x-auto">
982
+ <table class="min-w-full bg-white">
983
+ <thead class="bg-blue-800 text-white">
984
+ <tr>
985
+ <th class="py-3 px-4 text-left">Produto</th>
986
+ <th class="py-3 px-4 text-left">Indicação</th>
987
+ <th class="py-3 px-4 text-left">Dose</th>
988
+ <th class="py-3 px-4 text-left">Efeito Esperado</th>
989
+ </tr>
990
+ </thead>
991
+ <tbody class="text-gray-700">
992
+ <tr class="border-b border-gray-200">
993
+ <td class="py-3 px-4">Concentrado de hemácias</td>
994
+ <td class="py-3 px-4">Hb <7-8 g/dL (ou sintomático)</td>
995
+ <td class="py-3 px-4">1U eleva Hb ~1g/dL</td>
996
+ <td class="py-3 px-4">↑ Capacidade transporte O₂</td>
997
+ </tr>
998
+ <tr class="border-b border-gray-200">
999
+ <td class="py-3 px-4">PFC</td>
1000
+ <td class="py-3 px-4">TAP >1.5x ou sangramento</td>
1001
+ <td class="py-3 px-4">10-15 mL/kg</td>
1002
+ <td class="py-3 px-4">Correção fatores coagulação</td>
1003
+ </tr>
1004
+ <tr class="border-b border-gray-200">
1005
+ <td class="py-3 px-4">Crioprecipitado</td>
1006
+ <td class="py-3 px-4">Fibrinogênio <100-150 mg/dL</td>
1007
+ <td class="py-3 px-4">1U/10kg</td>
1008
+ <td class="py-3 px-4">↑ Fibrinogênio ~50mg/dL</td>
1009
+ </tr>
1010
+ <tr>
1011
+ <td class="py-3 px-4">Plaquetas</td>
1012
+ <td class="py-3 px-4">Plaquetas <50.000/mm³</td>
1013
+ <td class="py-3 px-4">1U/10kg</td>
1014
+ <td class="py-3 px-4">↑ Plaquetas ~30.000/mm³</td>
1015
+ </tr>
1016
+ </tbody>
1017
+ </table>
1018
+ </div>
1019
+ </div>
1020
+ </div>
1021
+ </div>
1022
+
1023
+ <!-- Slide 15: Síndrome Pós-Reperfusão -->
1024
+ <div class="slide bg-gray-50">
1025
+ <div class="container mx-auto px-4 py-8">
1026
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
1027
+ <i class="fas fa-exclamation-triangle mr-4 text-blue-600"></i> Síndrome Pós-Reperfusão
1028
+ </h2>
1029
+
1030
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8 mb-8">
1031
+ <div>
1032
+ <div class="bg-white p-6 rounded-lg shadow">
1033
+ <h3 class="text-xl font-semibold text-red-600 mb-4">Fisiopatologia</h3>
1034
+ <ul class="list-disc pl-5 text-gray-700 space-y-2">
1035
+ <li>Liberação de mediadores inflamatórios</li>
1036
+ <li>Acidose metabólica</li>
1037
+ <li>Hipercalemia</li>
1038
+ <li>Disfunção miocárdica transitória</li>
1039
+ <li>Vasodilatação sistêmica</li>
1040
+ </ul>
1041
+ </div>
1042
+ </div>
1043
+
1044
+ <div>
1045
+ <div class="bg-white p-6 rounded-lg shadow">
1046
+ <h3 class="text-xl font-semibold text-red-600 mb-4">Manifestações Clínicas</h3>
1047
+ <ul class="list-disc pl-5 text-gray-700 space-y-2">
1048
+ <li>Hipotensão grave (PAM pode cair >30%)</li>
1049
+ <li>Bradicardia/arritmias</li>
1050
+ <li>Hipercalemia</li>
1051
+ <li>Coagulopatia exacerbada</li>
1052
+ <li>Hipotermia</li>
1053
+ </ul>
1054
+ </div>
1055
+ </div>
1056
+ </div>
1057
+
1058
+ <div class="bg-white p-6 rounded-lg shadow">
1059
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Manejo da Síndrome Pós-Reperfusão</h3>
1060
+ <div class="flowchart">
1061
+ <div class="flowchart-step bg-red-100 text-red-800 font-semibold">
1062
+ <i class="fas fa-exclamation-triangle mr-2"></i> Diagnóstico
1063
+ </div>
1064
+ <div class="flowchart-arrow"></div>
1065
+ <div class="flowchart-step bg-yellow-100 text-yellow-800 font-semibold">
1066
+ <i class="fas fa-syringe mr-2"></i> Calcio gluconato 10% (10-30mg/kg)
1067
+ </div>
1068
+ <div class="flowchart-arrow"></div>
1069
+ <div class="flowchart-step bg-blue-100 text-blue-800 font-semibold">
1070
+ <i class="fas fa-prescription-bottle mr-2"></i> Vasopressores (Noradrenalina)
1071
+ </div>
1072
+ <div class="flowchart-arrow"></div>
1073
+ <div class="flowchart-step bg-green-100 text-green-800 font-semibold">
1074
+ <i class="fas fa-heart mr-2"></i> Inotrópicos se necessário
1075
+ </div>
1076
+ <div class="flowchart-arrow"></div>
1077
+ <div class="flowchart-step bg-purple-100 text-purple-800 font-semibold">
1078
+ <i class="fas fa-vial mr-2"></i> Bicarbonato se acidose grave (pH<7.2)
1079
+ </div>
1080
+ </div>
1081
+ <div class="mt-4 text-sm text-gray-600">
1082
+ <p><span class="font-semibold">Nota:</span> A síndrome geralmente é autolimitada, durando 5-15 minutos. Manter calma e seguir protocolo.</p>
1083
+ </div>
1084
+ </div>
1085
+ </div>
1086
+ </div>
1087
+
1088
+ <!-- Slide 16: Extubação e Despertar -->
1089
+ <div class="slide bg-gradient-to-br from-blue-900 to-blue-700 text-white">
1090
+ <div class="container mx-auto px-4 py-8">
1091
+ <h2 class="text-3xl font-bold mb-6 flex items-center">
1092
+ <i class="fas fa-lungs mr-4"></i> Extubação e Despertar
1093
+ </h2>
1094
+
1095
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-8 mb-8">
1096
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
1097
+ <h3 class="text-xl font-semibold mb-4">Critérios para Extubação</h3>
1098
+ <ul class="space-y-3">
1099
+ <li class="flex items-start">
1100
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
1101
+ <span>Paciente acordado e responsivo</span>
1102
+ </li>
1103
+ <li class="flex items-start">
1104
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
1105
+ <span>Capacidade ventilatória adequada</span>
1106
+ </li>
1107
+ <li class="flex items-start">
1108
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
1109
+ <span>Hemodinâmica estável</span>
1110
+ </li>
1111
+ <li class="flex items-start">
1112
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
1113
+ <span>Temperatura >36°C</span>
1114
+ </li>
1115
+ <li class="flex items-start">
1116
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
1117
+ <span>Bom controle da dor</span>
1118
+ </li>
1119
+ <li class="flex items-start">
1120
+ <i class="fas fa-check-circle text-green-300 mt-1 mr-3"></i>
1121
+ <span>Coagulação adequada</span>
1122
+ </li>
1123
+ </ul>
1124
+ </div>
1125
+
1126
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
1127
+ <h3 class="text-xl font-semibold mb-4">Contraindicações para Extubação</h3>
1128
+ <ul class="space-y-3">
1129
+ <li class="flex items-start">
1130
+ <i class="fas fa-times-circle text-red-300 mt-1 mr-3"></i>
1131
+ <span>Encefalopatia hepática grave</span>
1132
+ </li>
1133
+ <li class="flex items-start">
1134
+ <i class="fas fa-times-circle text-red-300 mt-1 mr-3"></i>
1135
+ <span>Hipoxemia refratária</span>
1136
+ </li>
1137
+ <li class="flex items-start">
1138
+ <i class="fas fa-times-circle text-red-300 mt-1 mr-3"></i>
1139
+ <span>Instabilidade hemodinâmica</span>
1140
+ </li>
1141
+ <li class="flex items-start">
1142
+ <i class="fas fa-times-circle text-red-300 mt-1 mr-3"></i>
1143
+ <span>Sangramento ativo significativo</span>
1144
+ </li>
1145
+ <li class="flex items-start">
1146
+ <i class="fas fa-times-circle text-red-300 mt-1 mr-3"></i>
1147
+ <span>Edema de vias aéreas</span>
1148
+ </li>
1149
+ <li class="flex items-start">
1150
+ <i class="fas fa-times-circle text-red-300 mt-1 mr-3"></i>
1151
+ <span>Hipotermia grave</span>
1152
+ </li>
1153
+ </ul>
1154
+ </div>
1155
+ </div>
1156
+
1157
+ <div class="bg-blue-800 bg-opacity-50 p-6 rounded-lg">
1158
+ <h3 class="text-xl font-semibold mb-4">Protocolo FAST HUG</h3>
1159
+ <div class="grid grid-cols-2 md:grid-cols-3 gap-4">
1160
+ <div class="bg-blue-700 p-3 rounded">
1161
+ <span class="font-bold">F</span>eeding (nutrição)
1162
+ </div>
1163
+ <div class="bg-blue-700 p-3 rounded">
1164
+ <span class="font-bold">A</span>nalgesia
1165
+ </div>
1166
+ <div class="bg-blue-700 p-3 rounded">
1167
+ <span class="font-bold">S</span>edation (sedação)
1168
+ </div>
1169
+ <div class="bg-blue-700 p-3 rounded">
1170
+ <span class="font-bold">T</span>hromboprophylaxis
1171
+ </div>
1172
+ <div class="bg-blue-700 p-3 rounded">
1173
+ <span class="font-bold">H</span>ead of bed elevation
1174
+ </div>
1175
+ <div class="bg-blue-700 p-3 rounded">
1176
+ <span class="font-bold">U</span>lcer prevention
1177
+ </div>
1178
+ <div class="bg-blue-700 p-3 rounded">
1179
+ <span class="font-bold">G</span>lycemic control
1180
+ </div>
1181
+ </div>
1182
+ <p class="mt-4 text-blue-200">Avaliar todos os itens antes da extubação</p>
1183
+ </div>
1184
+ </div>
1185
+ </div>
1186
+
1187
+ <!-- Slide 17: Analgesia Pós-Operatória -->
1188
+ <div class="slide bg-white">
1189
+ <div class="container mx-auto px-4 py-8">
1190
+ <h2 class="text-3xl font-bold text-blue-800 mb-6 flex items-center">
1191
+ <i class="fas fa-pills mr-4 text-blue-600"></i> Analgesia Pós-Operatória
1192
+ </h2>
1193
+
1194
+ <div class="grid grid-cols-1 md:grid-cols-3 gap-4 mb-8">
1195
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-blue-500">
1196
+ <div class="text-blue-600 mb-2">
1197
+ <i class="fas fa-syringe text-2xl"></i>
1198
+ </div>
1199
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Opioides</h3>
1200
+ <ul class="text-sm text-gray-700 space-y-1">
1201
+ <li>Fentanil (0.5-1μg/kg/h)</li>
1202
+ <li>Morfina com cautela (metabolismo hepático)</li>
1203
+ <li>PCA (Patient Controlled Analgesia)</li>
1204
+ <li>Monitorar sedação excessiva</li>
1205
+ </ul>
1206
+ </div>
1207
+
1208
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-green-500">
1209
+ <div class="text-green-600 mb-2">
1210
+ <i class="fas fa-spray-can text-2xl"></i>
1211
+ </div>
1212
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Bloqueio Nervoso</h3>
1213
+ <ul class="text-sm text-gray-700 space-y-1">
1214
+ <li>Bloqueio TAP (Transversus Abdominis Plane)</li>
1215
+ <li>Bloqueio paravertebral</li>
1216
+ <li>Epidural (controversa em coagulopatia)</li>
1217
+ <li>Considerar ultrassom-guiado</li>
1218
+ </ul>
1219
+ </div>
1220
+
1221
+ <div class="bg-white p-4 rounded-lg shadow border-t-4 border-purple-500">
1222
+ <div class="text-purple-600 mb-2">
1223
+ <i class="fas fa-capsules text-2xl"></i>
1224
+ </div>
1225
+ <h3 class="text-lg font-semibold text-gray-800 mb-2">Adjuvantes</h3>
1226
+ <ul class="text-sm text-gray-700 space-y-1">
1227
+ <li>Paracetamol (4g/dia máximo)</li>
1228
+ <li>Dexametasona (4-8mg EV)</li>
1229
+ <li>Ketamina em infusão (0.1-0.2mg/kg/h)</li>
1230
+ <li>Gabapentina (100-300mg 8/8h)</li>
1231
+ </ul>
1232
+ </div>
1233
+ </div>
1234
+
1235
+ <div class="bg-white p-6 rounded-lg shadow">
1236
+ <h3 class="text-xl font-semibold text-gray-800 mb-4">Escalas de Avaliação da Dor</h3>
1237
+ <div class="grid grid-cols-1 md:grid-cols-2 gap-6">
1238
+ <div>
1239
+ <h4 class="font-medium text-blue-700 mb-2">Escala Visual Analógica (EVA)</h4>
1240
+ <div class="flex items-center mt-2">
1241
+ <span class="text-sm mr-2">0</span>
1242
+ <div class="w-full bg-gray-200 rounded-full h-2.5">
1243
+ <div class="bg-blue-600 h-2.5 rounded-full" style="width: 30%"></div>
1244
+ </div>
1245
+ <span class="text-sm ml-2">10</span>
1246
+ </div>
1247
+ <p class="text-sm text-gray-600 mt-1">0 = Sem dor; 10 = Pior dor imaginável</p>
1248
+ </div>
1249
+ <div>
1250
+ <h4 class="font-medium text-blue-700 mb-2">Escala Numérica (EN)</h4>
1251
+ <div class="flex
1252
+ </html>
prompts.txt ADDED
@@ -0,0 +1,2 @@
 
 
 
1
+ /Users/cyrofranklin/Desktop/Protocolo Tx Hepatico HUWC-Hsc.docx elabore uma apresentação de slides utilizando este arquivo como referencia. 50 slides bem ilustrativos com imagens, gráficos, tabelas e fluxogramas. publico alvo são médicos residentes do serviço de anestesiologia do hospital são domingos
2
+ /Users/cyrofranklin/Desktop/Protocolo Tx Hepatico HUWC-Hsc.docx elabore uma apresentação de slides utilizando este arquivo como referencia. 50 slides bem ilustrativos com imagens, gráficos, tabelas e fluxogramas. publico alvo são médicos residentes do serviço de anestesiologia do hospital são domingos