Síndrome hepatopulmonar: patogenia, diagnóstico e tratamento

Lima, Beatriz; Martinelli, Ana de Lôurdes Candolo; França, Alex Vianey Callado

doi:10.1590/s0004-28032004000400010

Cited by 13 publications

(2 citation statements)

References 82 publications

(108 reference statements)

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“…Associated with contrast echocardiography, the gasometric parameters, especially the alveolar-arterial oxygen gradient (P(A-a)O 2 ), were evaluated since the isolated analysis of the arterial oxygen pressure (PaO 2 ) may underestimate the true degree of hypoxemia. We defined a P(A-a) O 2 greater than 20 mmHg in our study due to its good accuracy demonstrated in previous studies (14,15) .…”

Section: Methodsmentioning

confidence: 97%

“…Hepatopulmonary syndrome (HPS), which is defined by a triad involving hepatic disease and/or portal hypertension, intrapulmonary Capacity of exercise and survival in patients with cirrhosis with and without hepatopulmonary syndrome after liver transplantation vascular dilations (IPVDs), and arterial oxygenation abnormalities (partial oxygen pressure (PaO 2 ) less than 70 millimeters of mercury (mmHg) or alveolar-arterial oxygen gradient (P(Aa)O 2 ) greater than 20 mmHg in ambient air), is one of the complications that may arise as a result of liver disease, demonstrating a prevalence of 16% to 24% according to previous studies in this population (9)(10)(11)(12)(13)(14)(15) .…”

Section: Introductionmentioning

confidence: 99%

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Capacity of Exercise and Survival in Patients With Cirrhosis With and Without Hepatopulmonary Syndrome After Liver Transplantation

Pereira

Galant

Rosa

et al. 2020

Arq. Gastroenterol.

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BACKGROUND: Hepatopulmonary syndrome (HPS) is a complication associated with cirrhosis that may contribute to worsening exercise capacity and reduced survival after liver transplantation (LT). OBJECTIVE: To evaluate exercise capacity, complications and survival after LT in patients with cirrhosis and HPS and to compare these results with the results of patients with cirrhosis without HPS. METHODS: A prospective cohort study, consisting initially of 178 patients, of whom 90 underwent LT (42 with HPS and 48 without HPS). A previous evaluation consisted of the six-minute walk test (6MWT), an exercise test and manovacuometry. Those who underwent LT were evaluated for the mechanical ventilation time (MV), noninvasive ventilation (NIV) use, and survival two years after the procedure. In the statistical analysis, we used the Kolmogorov-Smirnov test, Student’s t-test, the linear association square test, and the Kaplan-Meier survival curve. The data were analyzed with the SPSS 16.00 program and considered significant at P<0.05. RESULTS: The HPS group demonstrated a lower peak of oxygen consumption (VO2peak) (14.2±2.3 vs 17.6±2.6) P<0.001 and a shorter distance walked on the 6MWT (340.8±50.9 vs 416.5±91.4) P<0.001 before LT compared with the non-HPS group. The transplanted patients with HPS remained longer hours in MV (19.5±4.3 vs 12.5±3.3) P=0.02, required more NIV (12 vs 2) P=0.01, and had lower survival two years after the procedure (P=0.01) compared with the transplanted patients without HPS. CONCLUSION: Patients with HPS had worse exercise capacity before LT, more complications and shorter survival after this procedure than patients without HPS.

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Section: Methodsmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Capacity of Exercise and Survival in Patients With Cirrhosis With and Without Hepatopulmonary Syndrome After Liver Transplantation

Pereira

Galant

Rosa

et al. 2020

Arq. Gastroenterol.

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The Relationship Between Severity of Liver Cirrhosis and Pulmonary Function Tests

et al. 2007

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Pulmonary complications, mainly hepatopulmonary syndrome (HPS), are frequently observed in liver cirrhosis. In this study, the aim was to investigate the frequency of hypoxemia and impairment of pulmonary function tests (PFT) in patients with liver cirrhosis and to examine the relationships of these impairments with liver failure. A total of 39 patients with cirrhosis, 24 males and 15 females, were included in our study. The mean age of the patients was 47.5 +/- 17.2 years. Arterial blood gases, PFT, and carbon monoxide diffusion tests (DLCO) were performed in all patients. Out of 39 cirrhotic patients, 21 (53.8%) had ascites, whereas 18 (46.2%) did not. Seven patients were in the Child-Pugh A group, 21 in the Child-Pugh B group, and 11 patients were in the Child-Pugh C group. Hypoxia was found in 33.3% of the patients. Although the PaO2 and SaO2 values of patients with ascites were lower compared to those without ascites (P < 0.05), no statistically significant difference was determined in the comparison of hypoxia between the groups (P > 0.05). Among the PFT parameters, FEV1/FVC and FEF25-75% values were found to be lower in patients with ascites than those without (P < 0.05). No differences were established between these two groups of patients in terms of DLCO (P > 0.05). While no differences were found in comparison of the DLCO values in between the groups (P > 0.05), there was a statistically significant difference in the ratio of DLCO to the alveolar ventilation (DLCO/VA) in between the groups (P < 0.05). On the other hand, a negative correlation was found between the DLCO/VA and Child points when the relationship between the Child-Pugh score and PFT parameters were investigated (r = -0.371, P < 0.05). Consequently, a relationship was established between the severity of liver failure and diffusion tests showing pulmonary complications invasively. We believe diffusions tests should be performed in addition to the PFT in order to determine pulmonary involvements particularly in patients who are candidates for liver transplantation.

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Hepatopulmonary syndrome in patients with Schistosoma mansoni periportal fibrosis

et al. 2009

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Síndrome hepatopulmonar: patogenia, diagnóstico e tratamento

Abstract: The hepatopulmonary syndrome is a frequent disease that requires blood gas measurements for diagnosis. Liver transplantation is the treatment of choice for patients with the syndrome.

Cited by 13 publications

References 82 publications

Capacity of Exercise and Survival in Patients With Cirrhosis With and Without Hepatopulmonary Syndrome After Liver Transplantation

Capacity of Exercise and Survival in Patients With Cirrhosis With and Without Hepatopulmonary Syndrome After Liver Transplantation

The Relationship Between Severity of Liver Cirrhosis and Pulmonary Function Tests

Hepatopulmonary syndrome in patients with Schistosoma mansoni periportal fibrosis

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