Hepatopulmonary syndrome classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]

Overview

There is no established system for the classification of hepatopulmonary syndrome. Nevertheless, HPS can be classified in term of severity based on arterial blood gas analysis.

Classification

There is no established system for the classification of hepatopulmonary syndrome (HPS).[1]


HPS can be classified in term of severity based on atrial blood gas analysis, as follows:

  • Mild: Alveolar-arterial oxygen gradient above, or equal to<math>\geq</math> 15mmHg, partial pressure of oxygen <math>\geq</math> 80mmHg.
  • Moderate: Alveolar-arterial oxygen gradient <math>\geq</math>15mmHg, partial pressure of oxygen <math>\geq</math> 60 up to 80mmHg.
  • Severe: Alveolar-arterial oxygen gradient <math>\geq</math> 15mmHg, partial pressure of oxygen <math>\geq</math> 50 up to 60mmHg.
  • Very severe: Alveolar-arterial oxygen gradient <math>\geq</math>15mmHg, partial pressure of oxygen below 50 mmHg (< 300mmHg while the patient is breathing 100% oxygen).[2]

References

  1. Rodríguez-Roisin R, Krowka MJ (2008) Hepatopulmonary syndrome--a liver-induced lung vascular disorder. N Engl J Med 358 (22):2378-87. DOI:10.1056/NEJMra0707185 PMID: 18509123
  2. Krowka MJ, Fallon MB, Kawut SM, Fuhrmann V, Heimbach JK, Ramsay MA et al. (2016) International Liver Transplant Society Practice Guidelines: Diagnosis and Management of Hepatopulmonary Syndrome and Portopulmonary Hypertension. Transplantation 100 (7):1440-52. DOI:10.1097/TP.0000000000001229 PMID: 27326810