Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Douschan, P.
Hepatopulmonary Syndrome in Patients with
Compensated Cirrhosis
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 77
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- Autor*innen der Med Uni Graz:
- Douschan Philipp
- Betreuer*innen:
- Stauber Rudolf
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- Abstract:
- Background: Hepatopulmonary syndrome (HPS) is an under-diagnosed complication in chronic liver disease. Although it is most commonly detected in patients suffering from cirrhosis of the liver, there are also records of HPS in patients with chronic hepatitis or Budd-Chiari syndrome. Due to intrapulmonary vasodilatation and increased intrapulmonary shunting, the average arterial oxygen partial pressure (PaO2) decreases and leads to systemic hypoxemia. In patients with cirrhosis this hypoxemia may lead to further impairment of their general condition. It is reported that HPS influences perioperative mortality in patients who undergo orthotopic liver-transplantation (OLT). Therefore, HPS is most often recognized during the evaluation for liver transplantation in patients with decompensated cirrhosis. Its prevalence ranges from 5% to 32%. The aim of this study is to assess the prevalence of HPS in patients with compensated cirrhosis. Methods: 105 consecutive patients with cirrhosis referred to the Medical University of Graz including inpatients (medical ward) and outpatients (liver clinic) were enrolled. Patients were evaluated for severity and etiology of liver dysfunction and screened for the presence of HPS. In all patients, arterial oxygen saturation (SpO2) was determined in the upright position by a portable pulse oximeter. Patients with a SpO2 ¿ 97% underwent further pulmonary work-up including spirometry, arterial blood gas analysis, contrast enhanced transthoracic echocardiography and lung perfusion scintigraphy. Results: Mean SpO2 of our study population was 98.06% (SD 0.9). 27.6% (n= 29) had a SpO2 of 99%, 60% (n = 63) had a SpO2 of 98%, 5.7% (n = 6) had a SpO2 of 97%, 5.7% (n = 6) had a SpO2 of 96% and 1% (n = 1) had a SpO2 of 93%. Therefore, 13 patients (12.4%) had a SpO2 ¿ 97%. Complete examinations were conducted in six patients. Finally, just one patient with clinical HPS could be detected. Conclusion: Clinically significant HPS seems to be a rare finding among patients with compensated cirrhosis. Pulse oximetry is a convenient screening tool for detecting severe stages of HPS.