European Journal of Cardiovascular Medicine

Introduction: Pulmonary complications develop in patients suffering from liver disease either with or without Decompensation. Hypoxemia can develop in patients with liver cirrhosis due to massive ascites, active aggressive U.G.I. bleed, primary pulmonary or cardiovascular cause, or due to pulmonary complications of liver cirrhosis. Hypoxemia in liver cirrhosis patient should be evaluated for pulmonary complications of liver cirrhosis along-with other primary pulmonary or cardiac causes. Development of these complications worsen the prognosis of disease and modifies the line of management. This study was undertaken tofind out the prevalence of arterial hypoxemia and hepatopulmonary syndrome in patients of liver cirrhosis. Objectives: To determine the arterial hypoxemia using arterial blood gas analysis in liver cirrhosis. To further determine the intrapulmonary vascular dilatation and hepatopulmonary syndrome using 2d-Contrast enhanced echocardiography. Material and Methods: The cross-sectional study was conducted on 80 patients, aged 18 years and above, fulfilling the inclusion and exclusion criteria, diagnosed with chronic liver disease. The detailed history was taken followed by clinical examination which was done after due consent. All these patients underwent routine blood investigations, chest x-ray, ultrasonography, UGI endoscopy, 2samples of arterial blood gas analysis(one supine and other upright), and agitated saline enhanced 2D- Echocardiography to detect intra-pulmonary vasodilation. The patients who had arterial hypoxemia, orthodeoxia, and had intrapulmonary vasodilation were diagnosed to have Hepatopulmonary syndrome. Results: Six(6)out of those 80 patients had hypoxemia in the population which were included in the study. Among those 6 patients who had hypoxemia, 4 patients had Intra-pulmonary vessel dilation on saline agitated 2d-echocardiography and were labelled as Hepatopulmonary syndrome. Conclusion: The patients of liver cirrhosis presenting with hypoxia and other pulmonary manifestations, with or without Decompensation, should be evaluated for hepatopulmonary syndrome. The early detection of intra-pulmonary vessel dilatation leads to early modification of line of management and poor prognosis of liver disease can be explained at early stages.