Artículo
Hepatopulmonary syndrome: which blood gas analysis criteria and position should we use for diagnosis?
Autor/es | Grilo Bensusan, Israel
![]() ![]() ![]() ![]() Pascasio, Juan Manuel López Pardo, Francisco Jesús Ortega Ruiz, Francisco Tirado, Juan Luis Sousa, José Manuel Rodríguez Puras, María José Ferrer, María Teresa Gómez Bravo, Miguel Ángel ![]() ![]() ![]() ![]() ![]() ![]() ![]() Grilo Reina, Antonio |
Departamento | Universidad de Sevilla. Departamento de Cirugía Universidad de Sevilla. Departamento de Medicina Instituto de Biomedicina de Sevilla (IBIS) |
Fecha de publicación | 2017 |
Fecha de depósito | 2024-05-20 |
Publicado en |
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Resumen | Introduction: Different blood gas criteria have been used in
the diagnosis of hepatopulmonary syndrome (HPS).
Patients and methods: Arterial blood gases were prospec
tively evaluated in 194 cirrhotic candidates for ... Introduction: Different blood gas criteria have been used in the diagnosis of hepatopulmonary syndrome (HPS). Patients and methods: Arterial blood gases were prospec tively evaluated in 194 cirrhotic candidates for liver transplantation (LT) in the supine and seated position. Three blood gas criteria were analyzed: classic (partial pressure of oxygen [PaO2 ] < 70 mmHg and/or alveolar-arterial gradient of oxygen [A-a PO2 ] ≥ 20 mmHg), modern (A-a PO2 ≥ 15 mmHg or ≥ 20 mmHg in patients over 64) and the A-a PO2 ≥ threshold value adjusted for age. Results: The prevalence of HPS in the supine and seated posi tion was 27.8% and 23.2% (classic), 34% and 25.3% (modern) and 22.2% and 19% (adjusted for age), respectively. The proportion of severe and very severe cases increased in a seated position (11/49 [22.4%] vs 5/66 [7.6%], p = 0.02). No difference was observed in the pre-LT, post-LT and overall mortality in patients with HPS, regardless of the criteria used. Conclusion: Obtaining blood gas measurements in the supine position and the use of modern criteria are more sensitive for the diagnosis of HPS. Blood gas analysis with the patient seated detects a greater number of severe and very severe cases. The presence of HPS was not associated with an increase in mortality regardless of blood gas criterion used. |
Cita | Grilo Bensusan, I., Pascasio, J.M., López Pardo, F.J., Ortega Ruiz, F., Tirado, J.L., Sousa, J.M.,...,Grilo Reina, A. (2017). Hepatopulmonary syndrome: which blood gas analysis criteria and position should we use for diagnosis?. Revista Española de Enfermedades Digestivas, 109 (12), 843-849. https://doi.org/10.17235/reed.2017.4930/2017. |
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