Prevalence of Hepatopulmonary Syndrome in Cirrhosis Patients

Sankar, R (2008) Prevalence of Hepatopulmonary Syndrome in Cirrhosis Patients. Masters thesis, Madurai Medical College, Madurai.

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Abstract

Hepatopulmonary syndrome includes the triad of liver disease, arterial blood deoxygenation and intra pulmonary pulmonary shunts. This study was conducted to evaluate the Prevalence and clinical profile of hepatopulmonary syndrome and to study the clinical spectrum of HPS in cirrhotic patients. After institutional ethical clearance, with an informed consent and with rigid criteria, 73 patients were selected carefully and were evaluated on social, clinical and laboratory aspects. The data were entered in Micro soft Excel spread sheet and analyzed statistically. There were 57 males and 16 females; Mean age was 52.2 ± 13 years. Among 73 patients 25 were in child A, 37were in child B, 11were in child C. Commonest symptom was dyspnea which occurs in 88.9 % of patients with HPS, 47% of patients with IPVDS. Dyspnea was a reasonably sensitive but poorly specific clinical indicator of intrapulmonary shunt. In the absence of any cardiopulmonary disease this symptom could suggest a pulmonary vascular complication of liver disease. All the patients of HPS had cyanosis. Cyanosis was a strong predictive marker of HPS if strict exclusion criteria for cardiopulmonary diseases were followed. Dyspnea, cyanosis, clubbing, Spider naevi were significantly higher in HPS than other two groups. Hypoxemia is common in patients with chronic liver disease. A rare cause is HPS. Because other abnormalities (eg ascites) or minor shunts that couldn’t be detected by contrast echo may coexist in cirrhotic patients and contribute to respiratory insufficiency. Measurement of lowered PO2 alone is not sufficient to make diagnosis of HPS. In our study prevalence of HPS was 12.2%, subclinical HPS was 8.2%, and IPVDS was 23.2%. There is no significant relationship between HPS and age, sex, aetiology. Regarding aetiology in our study most common aetiology was alcohol. Though child score was higher in clinical HPS group but did not reach statistical significance.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalence ; Hepatopulmonary Syndrome ; Cirrhosis Patients.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 15 Mar 2018 05:46
Last Modified: 15 Mar 2018 06:08
URI: http://repository-tnmgrmu.ac.in/id/eprint/6248

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