Thai Journal of Gastroenterology

Article :
Prevalence of Hepatopulmonary Syndrome in Cirrhotic Patients without Intrinsic Cardiopulmonary Disease

Author :
Wuthiphong Chaiphornphathana, M.D.
Dejpont Lohana, M.D.
Rungthip Sukavanna, M.D.
Sayom Bunnaj, M.D.
Panupong Jiamsripong, M.D.
Warong Lapanun, M.D.
Krixada Sastravaha, M.D.
Chinnavat Sutthivana, M.D.
Winyoo Jantrasoontragul, M.D.

Abstract :

Background: The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, hypoxemia or increased Alveolar-arterial oxygen gradient, and intrapulmonary vasodilatation.  The presence of HPS
independently worsens prognosis of patients with cirrhosis.  Mortality of cirrhotic patients with HPS is higher than cirrhosis without HPS.

Objective: To determine the prevalence of HPS in cirrhotic patients that has still not been reported in
Thailand.

Patients and Methods: One hundred and fifty cirrhotic patients (103 males, 47 females) were enrolled
in this study .These patients underwent history taking, physical examination, laboratory data, pulse oximetry
(uprightposition) chest radiograph, imaging study, arterial blood gas analysis, pulmonary function test and transthoracic contrast echocardrogram. Diagnosis of HPS will be fulfilled and established with : 1) The presence of chronic liver disease.  2) Hypoxemia PaO  (70 mmHg or an upper limit-widened age-corrected alveolar-arterial 2 gradient greater than normal.  3) Intrapulmonary vascular dilatation, detected by transthoracic contrast echocardiography, and 4) absence of intrinsic cardiopulmonary disesse.

Results: Total numbers of the 150 consecutive cirrhotic patients were enrolled. Only three cases were
compatible with HPS. These 3 cases were distributed in all Child -Pugh classification. There was no significant difference in history, physical examination, laboratory tests to determine the predictor of HPS presentation.

Conclusion: In our study, prevalence of HPS in cirrhotic patients without intrinsic cardiopulmonary
disease is 2 percent.

[Thai J Gastroenterol 2006; 7(1): 11-17]

Keyword :
Hepatopulmonary syndrome, HPS, cirrhosis

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