Abstract

Hepatopulmonary syndrome (HPS) is a frequent complication of chronic liver disease and/or portal hypertension. It results from the accumulation of vasoactive mediators by the deficit of hepatic clearance, which causes intrapulmonary vascular dilatation, leading to hypoxia. The diagnosis is made by investigating intrapulmonary shunt plus arterial blood gas analysis with PaO2 lower than 80 in patients with chronic liver disease. It does not have the adequate clinical treatment and can be resolved after liver transplantation. The present study aims to observe, among patients with intrapulmonary shunt without HPS configuration, whether evolution to HPS criteria was observed during follow-up. In a hepatology outpatient clinic of a tertiary hospital in the Federal District were evaluated 93 patients. The intrapulmonary shunt was found in 45 of them, of which 20 did not meet the criteria for HPS. In these patients, a new arterial blood gas analysis was requested after one year to assess whether there was a change in PaO2. Two died from complications of cirrhosis, five were lost to follow-up, and 13 underwent the examination. Of those who experienced the study, three (23%) began to meet the criteria for HPS. In the statistical analysis, there was no statistical significance of the correlation between the variables studied and the outcome of progression to HPS. Conclusion: Patients with a pulmonary shunt may evolve in the follow-up with a reduction in PaO2, being necessary to identify them and adapt them to the best treatment, which may include the use of O2 at home and liver transplantation.

Keywords: Hepatopulmonary Syndrome; Intrapulmonary Shunt; Liver Cirrhosis; Portal Hypertension; Contrast Echocardiography

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Citation

Citation: Liliana Sampaio Costa Mendes., et al. “Evaluation of Patients with Intrapulmonary Shunt without Hepatopulmonary Syndrome at the Hepatology Outpatient Clinic of a Tertiary Hospital in Brazil". Acta Scientific Gastrointestinal Disorders 5.5 (2022): 30-34.

Copyright

Copyright: © 2022 Liliana Sampaio Costa Mendes., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.