Liver and lung: Hepatopulmonary syndrome

Kenneth T. Yen, Michael J. Krowka, Augustine S. Lee, David J. Kramer, Charles D. Burger

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Hepatopulmonary syndrome (HPS) is characterized by the triad of hepatic dysfunction, arterial hypoxemia, and intrapulmonary vascular dilatations. Patients with HPS may have symptoms of liver disease rather than respiratory symptoms, but typical respiratory signs and symptoms include exertional dyspnea, platypnea, and orthodeoxia. Portal hypertension, cutaneous spider nevi, and digital clubbing are highly suggestive of HPS. The diagnostic workup includes arterial blood gas measurements, contrast-enhanced echocardiography, and technetium 99m-labeled macroaggregated albumin scanning. Pulmonary angiography may be necessary to detect discrete arteriovenous communications. Pharmacologic agents, such as almitrine bismesylate, prostaglandin F, indomethacin, somatostatin, and methylene blue, have been used to treat HPS, but results have been meager. Transjugular intrahepatic portosystemic shunt may improve oxygenation, and orthotopic liver transplantation may offer the best possibility for improvement.

Original languageEnglish (US)
Pages (from-to)309-315
Number of pages7
JournalJournal of Critical Illness
Volume17
Issue number8
StatePublished - Aug 1 2002

Keywords

  • Angiographic evidence of pattern defects
  • Clinical Conclusions
  • Clinical features
  • Intrapulmonary vascular dilatations
  • Treatment options

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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  • Cite this

    Yen, K. T., Krowka, M. J., Lee, A. S., Kramer, D. J., & Burger, C. D. (2002). Liver and lung: Hepatopulmonary syndrome. Journal of Critical Illness, 17(8), 309-315.