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Hepatopulmonary syndrome: Clinical situation in a third level hospital in Puebla, México

Salazar-Marcelino, Alejandra Elizabeth , Herrera-García, José Carlos , Toledo-Estrada, Javier , Mendoza-Torres, Miguel Ángel , Romero-Ogawa, Teresita





2016, Number 1

2016; 75 (1)






ABSTRACT

Introduction: The hepatopulmonary syndrome (HPS) is one of the less frequent extrahepatic manifestations of liver failure. It has an incidence of 13 to 47%, with a survival of 40% at 2.5 years. Objective: Describe the diagnosis and clinical course of HPS in Mexican patients. Material and methods: Descriptive, observational, longitudinal study and ambilective. We studied 94 patients with clinical liver established as diagnostic criteria for HPS: suggestive clinical data as cough not associated with infectious processes, chest pain, dyspnea, orthodeoxia and/or platypnea, alveolar/arterial gradient of oxygen higher than 15 mmHg, intrapulmonary vasodilation evaluated by contrast echocardiography and pulmonary function tests by the Department of Pneumology Specialist Hospital May 5, ISSSTEP, Puebla, in the period from March 2014 to August 2014. Results: The presence of HPS in 4 patients (4.2%) was determined, the most prevalent etiology was associated by non-alcoholic liver disease in 35.1%, associated with alcohol in 24.4%, 15.9% viral and other 24.5%. The most common symptoms associated with HPS were dyspnea, chest pain and chronic cough. 100% of patients (4 patients) had varying degrees hypoxemia. The severity of the disease not listed by Child Pugh determines the appearance of symptoms. Conclusion: HPS occurs in 4.2% of patients, they have hypoxemia and elevation of the alveolar-arterial gradient. The severity of liver disease does not determine the development of the disease. Its early detection reduces mortality of patients.

KEYWORDS

Hepatopulmonary syndrome, cirrhosis, diagnosis.

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2016, Number 1

2016; 75 (1)