Source: Annual Congress 2001 - Disease of the pulmonary circulation
Disease area: Interstitial lung diseases, Pulmonary vascular diseases

Abstract

Portal hypertension (PHT) is a multisystemic disease, characterised by portosystemic collaterals. Although pulmonary manifestations are generally surpassed by hepatic disease, different series report about 20-40% of hypoxaemia and intrapulmonary shunts. We aimed to investigate the presence of hepatopulmonary syndrome (HPS) in patients without respiratory symptoms. Arterial blood gases and pulmonary function tests detects the patients having a high risk for HPS, though they are not enough for the exact diagnosis. 10 male and 7 female cases with the diagnosis of PHT in the sclerotherapy program of Paediatric Surgery Department of Cerrahpasa Medical Faculty were recruited for the study. In the arterial blood gases analysis, hypoxaemia was detected in 3 of the cases, while the rest of the patients showed PO2 greater than 95 mmHg. Orthodeoxia, a finding observed in HPS and defined as desaturation of arterial blood by 10% upon rising, was found in 3 of the cases. One patient did not cooperate in performing lung function tests, but the rest of the patients had normal FVC, FEV1, FEV1/FVC and FEF25-75% values. Maximum inspiratory pressure (Pimax) was evaluated in 14 cases, except for 1 case with a normal value, others showed decreased values. Maximum expiratory pressure (Pemax) had decreased in all the 14 cases the test could be performed. Diffusion capacity for carbon monoxide (DLco) was measured in 14 cases, 13 showed decreased values, 1 had a normal value. We conclude that, pulmonary assessment should be done in all cases with PHT, whether or not having respiratory symptoms, as early recognition of HPS leads to a higher success rate in hepatic transplantation which is the only treatment option.

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Citations should be made in the following way:
E. Yesildag, I. Keskinel, T. Demir, N. Yildirim, O. F. Senyuz (Istanbul, Turkey). Pulmonary functions and arterial blood gases in portal hypertension. Eur Respir J 2001; 16: Suppl. 31, 3517

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