Investigation of hepatopulmonary syndrome frequency in cirrhosis

Investigation of Hepatopulmonary Syndrome frequency in CirrhosisObjective: The aim of this study is to investigate hepatopulmonary syndromefrequency in cirrhosis patients with ortodeoxy which could be confirmed bytransthoracic echocardiography with contrast enhancement.Material and method: Ninety five (95) patients (67/28 M/F ) with the diagnosisof cirrhosis were included in the study. Mean age of the patients was 52,28±12,0 .Thecirrhosis patients? functional , clinical and etiological classifications were made.Arterialblood gas samples and measurements of portabl pulse oximetry were obtained in bothsupin and seated position breathing room air. The suitable patients? response to theoxygen therapy with nasal canul was evaluated. Hepatopulmonary syndrome bytransthoracic echocardiography with contrast enhancement was investigated in thepatients with hypoxaemia (Pa,02<85 mmHg, Sa,02<%97) in seated position. The severityand stage of hepatopulmonary syndrome were evaluated by MAA lung scanning andpulmonary angiography. Thoracic HRCT was used for excluding coexistent conditions.Data was enrolled into SPSS 16 packet program for statictical analysis.Results: Eight (8) patients with whom hepatopulmonary syndrome was definedhad hypoxaemia in seated position and positive contrast echocardiography.In these eightpatients, four patients (4) had type I hepatopulmonary syndrome and four patients (4) hadtype II hepatopulmonary syndrome .Six (6) patients were in Child C class and two (2)patients were in Child B class. Cirrhosis etiology was HCV in three (3) patient, HBV intwo (2) patients and in three (3) patients etiology was unknown. Pa,02 (arterial oxygentension) was ?70 mmHg in seven (7 ) patients.There was no significant result in MAAlung scanning and pulmonary anjıography.There was no coexistent condition withthoracic HRCT in 8 patients. In our study, age and Child class B and C were associatedwith HPS.Conclusion: In conclusion , eight of 95 (% 8,4) patients had hepatopulmonarysyndrome. Patients with hepatopulmonary syndrome were advanced in years and inChild B and C classes. İn cirrhosis patients with hypoxaemia in seated position, furtherstudies are needed to investigate hepatopulmonary syndrome.Key words: Cirrhosis, hepatopulmonary syndrome, hypoxaemia, transthoracic contrast echocardiography