Clinical–liver, pancreas, and biliary tractHepatopulmonary Syndrome in Patients With Hypoxic Hepatitis
Section snippets
Patients
A total of 646 patients were admitted to our intensive care unit (ICU) between October 2003 and May 2005. Forty-four patients fulfilled the criteria of HH and were screened for the presence of HPS.
The control group consisted of all the remaining 602 patients, who fulfilled the following criteria: (1) presence of cardiogenic pulmonary edema, pneumonia, acute respiratory distress syndrome, chronic obstructive pulmonary disease, pleural effusion, atelectasis, or pulmonary embolism; (2) no sign of
Study Population
Data were collected and analyzed in a total of 44 critically ill patients with HH. Figure 1 shows the recruitment algorithm of the study patients.
The median age of the study patients was 62 years (range, 22–83 years); 29 (66%) were men and 15 (34%) were women. The mean acute physiologic and chronic health evaluation III score was 82 ± 31. Demographic data and patients’ characteristics are summarized in Table 1.
Control Population
The control group consisted of 62 critically ill patients without HH but several
Discussion
HPS is a known complication of chronic liver disease associated with increased morbidity and mortality.1, 2, 25 Most of the clinical studies focused on patients with cirrhosis. There are only a few cases reporting the occurrence of HPS in patients without cirrhosis.3, 4, 5, 6, 7, 8, 9 A histopathologic study of the lungs in patients who died of fulminant hepatic failure revealed pleural spider nevi, diffuse dilatation of the pulmonary vascular bed affecting arteries, precapillary vessels, and
References (40)
- et al.
Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis
Gastroenterology
(2003) - et al.
Pulmonary dysfunction in non-cirrhotic patients with chronic viral hepatitis
Eur J Intern Med
(2002) - et al.
Hepatopulmonary syndrome in inferior vena cava obstruction responding to cavoplasty
Gastroenterology
(2000) - et al.
Prevalence of hepatopulmonary syndrome in cirrhosis and extrahepatic portal venous obstruction
Am J Gastroenterol
(2001) - et al.
Ischemic hepatitisclinical presentation and pathogenesis
Am J Med
(2000) - et al.
Ultrasonic contrast studies for the detection of cardiac shunts
J Am Coll Cardiol
(1984) - et al.
Measurement of right ventricular ejection fraction by contrast echocardiography
Int J Cardiol
(1997) - et al.
Contrast enhancement of Doppler signals by sonicated albumin for estimating right ventricular systolic pressure
Am J Cardiol
(1991) - et al.
Hepatopulmonary syndrome. Clinical observations and lack of therapeutic response to somatostatin analogue
Chest
(1993) - et al.
Hepatopulmonary syndromea pulmonary vascular complication of liver disease
Clin Chest Med
(1996)