Correlation between hepatopulmonary syndrome and oxygen saturation pulse oximetry in cirrhotic patients

Abstract

SUMMARY Hepatopulmonary Syndrome (HPS) is a complication of cirrhosis that worsens the disease's prognosis, pre and post liver transplant. The objective of this study is to analyze the prevalence of HPS in cirrhotic patients at our service and to correlate it with oxygen saturation (SatO2) using a pulse oximeter to evaluate if this is useful as a screening test for HPS. A prospective study was conducted in patients with hepatic cirrhosis conventionally selected from 2014 to 2016. All the patients underwent an echocardiogram with microbubbles and oxygen saturation measurement by pulse oximetry. Those with intrapulmonary shunt were submitted to arterial blood gas analysis. The relationship between oxygen saturation and HPS was assessed by the multivariate model of binary logistic regression. We analyzed 77 patients, and 23.3% (18 patients) had all criteria for HPS. The relationship between HPS and SatO2 did not show statistical significance, even after the variables were adjusted for sex, age, and smoking. Oxygen saturation alone was not able to detect HPS in the sample of cirrhotic patients. More accurate methods for screening and diagnosis of the syndrome should be used.

Advances in Diagnostic Imaging of Hepatopulmonary Syndrome

“…The severity of HPS can be classified according to the PaO 2 into either mild (PaO 2 ≥80 mmHg), moderate (PaO 2 60-79 mmHg), severe (PaO 2 50-59 mmHg), or very severe (PaO 2 <50 mmHg) (4). HPS mostly occurs in patients with liver cirrhosis, with an incidence rate of 9.45-42.5% (5)(6)(7)(8)(9)(10). HPS is a serious pulmonary complication of end-stage liver disease.…”

“…Early detection and timely treatment may help improve the prognosis. HPS should be considered if there is abnormal pulmonary arterial oxygenation in the presence of liver disease; however, abnormal blood oxygen saturation alone is not enough to diagnose HPS ( 9 ). The focus of clinical diagnosis is to identify evidence of PV in patients with chronic liver disease complicated with hypoxemia.…”