Liver and lung: How to manage portopulmonary hypertension

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

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Initially, most patients who have portopulmonary hypertension (portoPH) are asymptomatic or have subtle symptoms, and the disorder may be recognized only after the patient is anesthetized for orthotopic liver transplantation (OLT). The initial appearance of symptoms usually is associated with right ventricular dysfunction or low cardiac output. Dyspnea on exertion, peripheral edema, chest pain, and syncope are most common, but fatigue may occur also. Usually, a high degree of clinical suspicion, screening by Doppler echocardiography, and confirmation by right heart catheterization are needed to make the diagnosis. Various vasodilators, such as nitric oxide and epoprostenol, may be given. PortoPH patients with mean pulmonary artery pressures of 35 to 50 mm Hg and pulmonary vascular resistance of less than 250 dynes/s/cm5 may be good candidates for OLT.

Original languageEnglish (US)
Pages (from-to)401-406
Number of pages6
JournalJournal of Critical Illness
Volume17
Issue number10
StatePublished - Oct 1 2002

Keywords

  • Clinical Conclusions
  • Definition
  • Evaluation of secondary causes
  • Histopathologic clues
  • Management strategies
  • Pathophysiology
  • Signs and symptoms

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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