Hepatopulmonary syndrome screening
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Differentiating Hepatopulmonary syndrome from other Diseases |
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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 insufficient evidence to recommend routine screening for hepatopulmonary syndrome. Nevertheless, it should be considered as a differential diagnosis in every patient with known liver disease or sign and symptoms of liver disease that present with hypoxemia, and dyspnea. Nevertheless, serial pulse oximetry as a simple, low cost and widely available technique, is recommended in cirrhotic patients. It could detect and also determine the severity of hypoxemia in patients with hepatopulmonary syndrome. Hence, pulse oximetry screening might improve management of HPS in cirrhotic patients.
Screening
- There is insufficient evidence to recommend routine screening for hepatopulmonary syndrome. Nevertheless, it should be considered as a differential diagnosis in every patient with known liver disease or sign and symptoms of liver disease that present with hypoxemia, and dyspnea.[1][2][3][4][5]
- Nevertheless, serial pulse oximetry as a simple, low cost and widely available technique, is recommended in cirrhotic patients. It could detect and also determine the severity of hypoxemia in patients with hepatopulmonary syndrome. Hence, pulse oximetry screening might improve management of HPS in cirrhotic patients.[6]
Screening Algorithm
References
- ↑ Schenk P, Fuhrmann V, Madl C, Funk G, Lehr S, Kandel O et al. (2002) Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 51 (6):853-9. DOI:10.1136/gut.51.6.853 PMID: 12427789
- ↑ Abrams GA, Jaffe CC, Hoffer PB, Binder HJ, Fallon MB (1995) Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 109 (4):1283-8. PMID: 7557096
- ↑ Lima BL, França AV, Pazin-Filho A, Araújo WM, Martinez JA, Maciel BC et al. (2004) Frequency, clinical characteristics, and respiratory parameters of hepatopulmonary syndrome. Mayo Clin Proc 79 (1):42-8. DOI:10.4065/79.1.42 PMID: 14708947
- ↑ Martínez GP, Barberà JA, Visa J, Rimola A, Paré JC, Roca J et al. (2001) Hepatopulmonary syndrome in candidates for liver transplantation. J Hepatol 34 (5):651-7. PMID: 11434610
- ↑ Schenk P, Schöniger-Hekele M, Fuhrmann V, Madl C, Silberhumer G, Müller C (2003) Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. Gastroenterology 125 (4):1042-52. PMID: 14517788
- ↑ Arguedas MR, Singh H, Faulk DK, Fallon MB (2007) Utility of pulse oximetry screening for hepatopulmonary syndrome. Clin Gastroenterol Hepatol 5 (6):749-54. DOI:10.1016/j.cgh.2006.12.003 PMID: 17392034
- ↑ Krynytska I, Marushchak M, Mikolenko A, Bob A, Smachylo I, Radetska L et al. (2017) Differential diagnosis of hepatopulmonary syndrome (HPS): Portopulmonary hypertension (PPH) and hereditary hemorrhagic telangiectasia (HHT). Bosn J Basic Med Sci 17 (4):276-285. DOI:10.17305/bjbms.2017.2020 PMID: 28759737