Prevalence and determinants of hepatopulmonary syndrome in decompensated chronic liver disease

Khiangte, Benjamine; Kothakota, Sunil Raviraj; Sasidharan, Madhu; Harish, K; Joshi, Subhashchandra; Kumar, Vijosh V.; Kanala, Jagadeswara R.; C, Praveen Kumar; Nair, Ajith K.

doi:10.1007/s12664-020-01052-9

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…[ 3 ] An Austrian and an Indian study showed a very high prevalence of HPS in cirrhosis (27.5% and 40.6%, respectively). [ 3 15 ] The presence of HPS was significantly more common in patients with poorer CTP score, which was a finding similar to our study.…”

Section: Discussionsupporting

confidence: 91%

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Pulmonary Dysfunction in Patients with Cirrhosis of the Liver: A Study of Pulmonary Function Tests and Arterial Blood Gases

Vaishnav,

Barla,

Ruchitha

et al. 2024

International Journal of Applied &Amp; Basic Medical Research

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Background and Aim: Respiratory complications in liver cirrhosis can occur due to various mechanisms, such as ascites causing restricted lung expansion and opening of intrapulmonary vascular shunts due to high portal pressures. We aimed to study the effects of the liver dysfunction on the lungs by evaluating arterial blood gas (ABG) and pulmonary function test (PFT) of all study subjects. Subjects and Methods: A cross-sectional study was done between August 2020 and September 2022. Diagnosed cases of the liver cirrhosis were enrolled in the study after informed consent and were subjected to the following investigations: chest X-ray, oximetry, spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), two-dimensional echocardiography, and ABG analysis (ABGA). The cases were divided into three groups based on their Child–Pugh staging, and statistical analysis was done on the collected data. Results: A total of 64 (53 males and 11 females) patients with an average age of 49.82 ± 9.89 years were studied. Alcoholism was the most common cause of cirrhosis in males. Breathlessness (65.6%) and pleural effusion (26.6%) were the most common respiratory symptoms and signs, respectively. Seventeen patients had hepatic hydrothorax, eight patients had hepatopulmonary syndrome (HPS), and six patients had portopulmonary hypertension. Low pH (17.2%) and oxygen partial pressure (PaO2) (20.3%) were the most common ABGA findings. The pH, PaO2, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), and DLCO were significantly low in Child Pugh Stage C (P < 0.05). The pH, pO2, HCO3, FEV1, FVC, FEV1/FVC, and DLCO were significantly lower in patients with HPS (P < 0.05). Conclusion: Metabolic acidosis and low FEV1/FVC and DLCO were the common findings in study subjects. Pulmonary dysfunction was common in advanced liver cirrhosis. Patients with HPS had worse ABG and PFT parameters than those without HPS.

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Section: Discussionsupporting

confidence: 91%

“…[ 13 14 ] Interestingly, in a recent study carried out in India on 64 subjects with cirrhosis, nonalcoholic fatty liver disease (43.8%) was the most common cause of cirrhosis, followed by alcoholism (26.6%). [ 15 ] This may reflect the changing etiological pattern of cirrhosis of the liver with changes in Indian lifestyle.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Dysfunction in Patients with Cirrhosis of the Liver: A Study of Pulmonary Function Tests and Arterial Blood Gases

Vaishnav,

Barla,

Ruchitha

et al. 2024

International Journal of Applied &Amp; Basic Medical Research

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“…Khiangte and colleagues report a cross-sectional observational study to determine the prevalence and determinants of HPS in CLD [16]. HPS was diagnosed in 26 of 64 patients, consistent with previously reported literature.…”

Section: Prevalence and Determinants Of Hepatopulmonary Syndrome In Decompensated Chronic Liver Diseasesupporting

confidence: 73%

“…Spider naevi, clubbing, palmar erythema and orthodeoxia were significantly associated with the risk of HPS, although etiology of CLD was not. On multivariate analysis, a higher Model for Endstage Liver Disease (MELD)-Na score, hepatic encephalopathy and impaired diffusion capacity of lung for carbon monoxide (DLCO) were independently associated with risk of HPS [16]. A suitable index of suspicion taken together with adverse clinical parameters may facilitate earlier referral for LT as discussed by authors.…”

Section: Prevalence and Determinants Of Hepatopulmonary Syndrome In Decompensated Chronic Liver Diseasementioning

confidence: 99%

Indian Journal of Gastroenterology July–August 2020

Limdi

2020

Indian J Gastroenterol

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“…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.…”

Section: Introductionmentioning

confidence: 99%

Advances in Diagnostic Imaging of Hepatopulmonary Syndrome

Luo

2022

Front. Med.

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Hepatopulmonary syndrome (HPS) is a serious pulmonary complication of progressive liver disease that leads to a poor clinical prognosis. Patients with HPS may develop acute respiratory failure, which requires intensive care and therapy. At present, the only effective treatment is liver transplantation; therefore, early diagnosis and timely treatment are of considerable significance. The three main features of HPS are liver disease, oxygenation disorder, and intrapulmonary vascular dilatation (IPVD). Diagnosing HPS is challenging due to the difficulty in detecting the presence or absence of IPVD. As such, imaging examination is very important for detecting IPVD. This paper reviews the imaging methods for diagnosing HPS such as ultrasound, dynamic pulmonary perfusion imaging, pulmonary angiography, and computed tomography.

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Prevalence and determinants of hepatopulmonary syndrome in decompensated chronic liver disease

Cited by 6 publications

References 20 publications

Pulmonary Dysfunction in Patients with Cirrhosis of the Liver: A Study of Pulmonary Function Tests and Arterial Blood Gases

Pulmonary Dysfunction in Patients with Cirrhosis of the Liver: A Study of Pulmonary Function Tests and Arterial Blood Gases

Indian Journal of Gastroenterology July–August 2020

Advances in Diagnostic Imaging of Hepatopulmonary Syndrome

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