Pulmonary Complications of Cirrhosis

The Use of a PleurX Catheter in the Management of Recurrent Benign Pleural Effusion: A Concise Review

“…Among patients with cirrhotic liver disease, about 15% develop PE, which is also called hepatic hydrothorax. The PE is usually multifactorial and mainly explained by multiple tiny diaphragmatic defects in association with low serum albumin levels [9][10][11]. In hepatic hydrothorax, the initial approach includes a salt-restricted diet in addition to diuretic drugs such as loop diuretics and potassium-sparing agents.…”

Respiratory Complication in Liver Disease

“…This diffusion impairment is worsened by the increased cardiac output associated with liver disease because the transit time of red blood cells through the pulmonary vasculature is reduced and hence the time available for diffusion is also reduced. 1,4,6 Multiple mechanisms have been proposed to explain IPVD. Increased pulmonary production of nitric oxide has been implicated to play a key role.…”

Use of a Tunnelled Pleural Catheter for the Management of Refractory Hepatic Hydrothorax: A New Therapeutic Option

“…Two currently accepted theories consist of: (1) hypoalbuminemia and decreased intravascular colloid osmotic pressure secondary to diminished protein synthesis and (2) direct passage of ascitic fluid into the pleural space through minute diaphragmatic defects. These small congenital defects tend to enlarge in patients with ascites-induced elevation of peritoneal pressure, further facilitating fluid passage into the pleural cavity [2,3,4,5]. Translocation of ascitic fluid from the peritoneal cavity to the pleural space has been demonstrated by several methods.…”

“…Moreover, potential renal function impairment and the risk of electrolyte imbalance might not allow an increase in dosage. In such circumstances, more invasive therapeutic strategies should be considered [2,3,4,5]. …”