2024-05-202024-05-202017Grilo 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.2017.4930/2017.1130-01082340-4167https://hdl.handle.net/11441/158695Introduction: 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.application/pdf7 p.engAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/CirrhosisAscitesContrast echocardiographyPulmonary vascular diseasesMacro-aggregated albumin lung perfusion scan and perioperative careinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccess10.17235/reed.2017.4930/2017