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Colegio de Medicos y Cirujanos República de Costa Rica

2014, Number 611

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Rev Med Cos Cen 2014; 71 (611)

Sindrome Hepatopulmonar

Muñoz JG

Language: Spanish
References: 23
Page: 395-401
PDF size: 515.90 Kb.


ABSTRACT

Hepatopulmonary Syndrome (HPS) is characterized by defects in blood oxygenation due to pulmonary abnormalities that develops in patients with liver cirrhosis. The pathophysiological mechanisms that explain the development of HPS in cirrhotic patients is not yet clear, but a deficit in hepatic clearance of various vascular markers has been proposed as a fundamental theory. Patients with this syndrome have pulmonary parenchymal disease, but can manifest platypnea-orthodeoxia the unusual finding of increased hypoxemia with the change from a supine to a standing position. A key factor in the diagnosis of SHP is the exclusion of other causes that may be involved in cirrhosis who have hypoxemia (cardiopulmonary disorders, pulmonary atelectasis, pneumonia, ascites, pulmonary edema or hepatic hydrothorax) , therefore you should consider the SHP in the differential diagnosis of dyspnea and hypoxemia . Liver transplantation is considered the definitive treatment for refractory cases with severe hypoxemia. This review aims to provide an update on the subject, with particular emphasis on the need for diagnosis and treatment recommendations.


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