Influence of transjugular intrahepatic portosystemic shunts (TIPS) on tissue oxygenation in patients with cirrhosis

Denié, C.; Vachiéry, Florence; Gadano, Adrián; Sogni, Philippe; Elman, A; Moreau, Richard; Valla, Dominique; Lebrec, Didier

doi:10.1111/j.1600-0676.1998.tb00159.x

Cited by 3 publications

(3 citation statements)

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“…Hepatopulmonary syndrome, an infrequent complication of chronic liver disease usually associated with portal hypertension and cirrhosis, is manifested by dyspnea, platypnea and orthopnea and nowadays is more widely diagnosed occurring in chronic liver disease of all types and mainly in severe suffering patients 4, 9, 10, 11.…”

Section: Discussionmentioning

confidence: 99%

“…Shunts observed in patients with severe liver disease resulting in blood gas alterations may be contributed to portopulmonary shunt due to the portal hypertension development as well as to intrapulmonary arteriovenous shunt and V A /Q inequality. Hepatopulmonary syndrome, an infrequent complication of chronic liver disease usually associated with portal hypertension and cirrhosis, is manifested by dyspnea, platypnea and orthopnea and nowadays is more widely diagnosed occurring in chronic liver disease of all types and mainly in severe suffering patients 4 , 9 , 10 , 11 .…”

Section: Discussionmentioning

confidence: 99%

“…in hereditary hemorrhagic teleangiectasia (Rendu Osler Weber disease) where the lesion is transmitted as a simple non-sex-linked dominant and the disorder is observed in the lungs as single or multiple lesions, or may be acquired 2 . Intrapulmonary arteriovenous shunt and portopulmonary shunt may be acquirely observed in patients with chronic liver disease 3 , 4 , 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

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Alterations in Arterial Blood Parameters in Patients with Liver Cirrhosis and Ascites

Charalabopoulos

Peschos²,

Zoganas³

et al. 2007

Int. J. Med. Sci.

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In cirrhotic patients, in addition to hepatocytes and Kuppfer cells dysfunction circulatory anatomic shunt and ventilation/perfusion (V A / Q) ratio abnormalities can induce decrease in partial pressure of oxygen in arterial blood (PaO 2 ), in oxygen saturation of hemoglobin (SaO 2 ) as well as various acid-base disturbances. We studied 49 cases of liver cirrhosis (LC) with ascites compared to 50 normal controls. Causes were: posthepatic 37 (75.51%), alcoholic 7 (14.24%), cardiac 2 (4.08%), and cryptogenic 3 (6.12%). Complications were: upper gastrointestinal bleeding 24 (48.97), hepatic encephalopathy 20 (40.81%), gastritis 28 (57.14%), hepatoma 5 (10.2%), renal hepatic syndrome 2 (4.01%), HbsAg (+) 24 (48.97%), and hepatic pleural effusions 7 (14.28%). Average PaO 2 and SaO 2 were 75.2 mmHg and 94.5 mmHg, respectively, compared to 94.2 mmHg and 97.1 mmHg of the control group, respectively (p value in both PaO 2 and SaO 2 was p<0.01). Respiratory alkalosis, metabolic alkalosis, metabolic acidosis, respiratory acidosis and metabolic acidosis with respiratory alkalosis were acid-base disturbances observed. In conclusion, portopulmonary shunt, intrapulmonary arteriovenous shunt and V A /Q inequality can induce a decrease in PaO 2 and SaO 2 as well as various acid-base disturbances. As a result, pulmonary resistance is impaired and patients more likely succumb to infections and adult respiratory distress syndrome.

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Section: Discussionmentioning

confidence: 99%