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Гепатопульмональный синдром
Гепатопульмональный синдром
Авдеев С.Н. Гепатопульмональный синдром. Consilium Medicum. 2016; 18 (3): 30–35. DOI: 10.26442/2075-1753_2016.3.30-35
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Аннотация
Гепатопульмональный синдром (ГПС) является частым осложнением терминальных заболеваний печени. В основе ГПС лежит развитие дилатации легочных сосудов в ответ на повышение концентрации циркулирующих вазоактивных субстанций. Для постановки диагноза ГПС необходима триада признаков: заболевание печени и/или портальная гипертензия, дилатация легочных сосудов и гипоксемия. Основными лечебными мероприятиями при ГПС являются кислородотерапия и ортотопическая трансплантация печени.
Ключевые слова: гепатопульмональный синдром, гипоксемия, цирроз печени.
Ключевые слова: гепатопульмональный синдром, гипоксемия, цирроз печени.
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Hepatopulmonary syndrome (HPS) is a frequent complication of terminal liver disease. The HPS is based on the development of pulmonary vascular dilatation in response to the increase in the concentration of circulating vasoactive substances. To diagnose with HPS, the triad of symptoms is required: liver disease and/or portal hypertension, pulmonary vascular dilatation, and hypoxemia. The main therapeutic measures in HPS are the oxygen therapy and orthotopic liver transplantation.
Key words: hepatopulmonary syndrome, hypoxemia, cirrhosis of the liver.
Key words: hepatopulmonary syndrome, hypoxemia, cirrhosis of the liver.
Полный текст
Список литературы
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9. Abrams GA, Jaffe CC, Hoffer PB et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 1995; 109: 1283–8.
10. Seward JB, Hayes DL, Smith HC et al. Platypnea-orthodeoxia: clinical profile, diagnostic work-up, management and report of 7 cases. Mayo Clin Proc 1984; 59: 221–31.
11. Rolla G, Brussino L, Colagrande P et al. Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 1997; 26: 842–7.
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30. Henriksen JH, Staun-Olsen P, Fahrenkrug P et al. Vasoactive intestinal polypeptide (VIP) in cirrhosis: arteriovenous extraction in different vascular beds. Scand J Gastroenterol 1980; 15: 787–92.
31. Hortnagl H, Singer EA, Lenz K et al. Substance-P is markedly increased in plasma of patients with hepatic coma. Lancet 1984; 1: 480–3.
32. Gines P, Jimenez W, Arroyo V et al. Atrial natriuretic factor in cirrhosis with ascites: Plasma levels, cardiac release and splanchnic extraction. Hepatology 1988; 8: 636–42.
33. Gómez FP, Barberà JA, Roca J et al. Effects of nebulized N(G)-nitro-L-arginine methyl ester in patients with hepatopulmonary syndrome. Hepatology 2006; 43: 1084–91.
34. Dinh-Xuan AT, Naeije R. The hepatopulmonary syndrome: NO way out? Eur Respir J 2004; 23: 661–2.
35. Davis HH, 2nd, Schwartz DJ, Lefrak SS et al. Alveolar-capillary oxygen disequilibrium in hepatic cirrhosis. Chest 1978; 73: 507–11.
36. Edell ES, Cortese DA, Krowka MJ et al. Severe hypoxemia and liver disease. Am Rev Respir Dis 1989; 140: 1631–5.
37. Rydell R, Hoffbauer FW. Multiple pulmonary arteriovenous fistulas in juvenile cirrhosis. Am J Med 1956; 21: 450–60.
38. Berthelot P, Walker JG, Sherlock S et al. Arterial changes in the lungs in cirrhosis of the liver – lung spider nevi. N Engl J Med 1966; 274: 291–8.
39. Robin ED, Horn B, Goris ML et al. Detection, quantitation and pathophysiology of lung spiders. Trans Assoc Am Physicians 1975; 88: 202–16.
40. Genovesi MG, Tierney DF, Taplin GV et al. An intravenous radio-nuclide method to evaluate hypoxemia caused by abnormal alveolar vessels. Limitation of conventional techniques. Am Rev Respir Dis 1976; 114: 59–65.
41. Wolfe JD, Tashkin DP, Holly FE et al. Hypoxemia of cirrhosis: detection of abnormal small pulmonary vascular channels by a quantitative radionuclide method. Am J Med 1977; 63: 746–54.
42. Williams A, Trewby P, Williams R et al. Structural alterations to the pulmonary circulation in fulminant hepatic failure. Thorax 1979; 34: 447–53.
43. Gotway MB, Dotson RH, Dawn SK. Hypoxemia in a patient with end-stage liver disease. Clin Pulm Med 2005; 12: 61–6.
44. Thorens JB, Junod AF. Hypoxemia and liver cirrhosis: a new argument in favour of a diffusion-perfusion defect. Eur Respir J 1992; 5: 754–6.
45. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
46. Schenk P, Fuhrmann V, Madl C et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 2002; 51: 853–9.
47. Rodriguez-Roisin R, Krowka MJ et al. ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 2004; 24: 861–80.
48. Offer J, Green L, Houghton AR, Campbell J. A case of hepatopulmonary syndrome. Echo Res Pract 2015; 2: K25–7.
49. Kamath PS. Portopulmonary hypertension and hepatopulmonary syndrome. J Gastroenterol Hepatol 2002; 17: S253–5.
50. Shub C, Tajik AJ, Seward JB et al. Detecting intrapulmonary right-to-left shunt with contrast echocardiography: observations in a patient with diffuse pulmonary arteriovenous fistulas. Mayo Clin Proc 1976; 51: 81–4.
51. Karabulut A, Iltumur K, Yalcin K et al. Hepatopulmonary syndrome and right ventricular diastolic functions: an echocardiographic examination. Echocardiography 2006; 23: 271–8.
52. Zamirian M, Aslani A, Shahrzad S. Left atrial volume: A novel predictor of hepatopulmonary syndrome. Am J Gastroenterol 2007; 102: 1392–6.
53. Wang YW, Lin HC. Recent advances in hepatopulmonary syndrome. J Chin Med Assoc 2005; 68: 500–5.
54. Abrams GA, Nanda NC, Dubovsky EV et al. The use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach. Gastroenterology 1998; 114: 305–10.
55. Ferreira MAP, Barreto SSM, Knorst MM et al. Semiquantitative echocardiographic evaluation of intrapulmonary vascular dilatations: correlation with evaluation of shunt levels and pulmonary function parameters. J Bras Pneumol 2009; 35: 106–13.
56. Scott VL, Dodson SF, Kang Y. The hepatopulmonary syndrome. Surg Clin North Am 1999; 79: 23–41.
57. Ryu JK, Oh JH. Hepatopulmonary syndrome: angiography and therapeutic embolization. Clin Imaging 2003; 27: 97–100.
58. Castro M, Krowka MJ. Hepatopulmonary syndrome: a pulmonary vascular complication of liver disease. Clin Chest Med 1996; 17: 35–48.
59. Saad NEA, Lee DE, Waldman DL et al. Pulmonary arterial coil embolization for the management of persistent Type 1 hepatopulmonary syndrome after liver transplantation. J Vasc Interv Radiol 2007; 18: 1576–80.
60. McAdams HP, Erasmus J, Crockett R, et al. The hepatopulmonary syndrome: radiologic findings in 10 patients. AJR Am J Roentgenol 1996; 166: 1379–85.
61. Lee KN, Lee HJ, Shin WW et al. Hypoxemia and liver cirrhosis (hepatopulmonary syndrome) in eight patients: comparison of the central and peripheral pulmonary vasculature. Radiology 1999; 211: 549–53.
62. Soderman C, Juhlin-Dannfelt A, Lagerstrand L et al. Ventilation-perfusion relationships and central haemodynamics in patients with cirrhosis. Effects of a somatostatin analogue. J Hepatol 1994; 21: 52–7.
63. Cadranel J, Milleron B, Cadranel JF et al. Severe hypoxemia associated intrapulmonary shunt in a patient with chronic liver disease: improvement after medical treatment. Am Rev Respir Dis 1992; 146: 526–7.
64. Milhe F, Reynaud-Gaubert M, Magnan A et al. Oxygenation improvement with almitrine bismesylate in the hepatopulmonary syndrome. Respiratory Medicine Extra 2006; 2: 81–4.
65. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
66. Nakos G, Evrenoglou D, Vassilakis N et al. Haemodynamics and gas exchange in liver cirrhosis: the effect of orally administered almitrine bimesylate. Respir Med 1993; 87: 93–8.
67. Rabiller A, Nunes H, Lebrec D et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med 2002; 166: 514–7.
68. Zhang J, Ling Y, Tang L et al. Pentoxifylline attenuation of experimental hepatopulmonary syndrome. J Appl Physiol 2007; 102: 949–55.
69. National Institutes of Health Pilot study of pentoxifylline for hepatopulmonary syndrome [online]: identifier: NCT00593658. 2008. http://clinicaltrials.gov/ct2/show/
NCT00593658?term=NCT00593658&rank=1
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2. Stoller JK, Lange PA, Westveer MK et al. Prevalence and reversibility of the hepatopulmonary syndrome after liver transplantation – The Cleveland Clinic Experience. West J Med 1995; 163: 133–8.
3. Hopkins WE, Waggoner AD, Barzilai B. Frequency and significance of intrapulmonary right-to-left shunting in end-stage hepatic disease. Am J Cardiol 1992; 70: 516–9.
4. Swanson KL, Weiner RH, Krowka MJ. Natural history of hepatopulmonary syndrome: Impact of liver transplantation. Hepatology 2005; 41: 1122–9.
5. Grace JA, Angus PW. Hepatopulmonary Syndrome: Update on Recent Advances in Pathophysiology, Investigation, and Treatment. J Gastroenterol Hepatol 2013; 28: 213–9.
6. Nacif LS, Andraus W, Pinheiro RS et al. The hepatopulmonary syndrome. Arq Bras Cir Dig 2014; 27: 145–7.
7. Fluckiger M. Vorkommen von trommelschlägelförmigen finger-endphalengen ohne chronische veränderungen an der lungen oder am herzen. Wien Med Wschr 1884; 34: 1457.
8. Kennedy TC, Knudson RJ. Exercise-aggravated hypoxemia and orthodexia in cirrhosis. Chest 1997; 72: 305–9.
9. Abrams GA, Jaffe CC, Hoffer PB et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 1995; 109: 1283–8.
10. Seward JB, Hayes DL, Smith HC et al. Platypnea-orthodeoxia: clinical profile, diagnostic work-up, management and report of 7 cases. Mayo Clin Proc 1984; 59: 221–31.
11. Rolla G, Brussino L, Colagrande P et al. Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 1997; 26: 842–7.
12. Robin ED, Laman D, Horn BR et al. Platypnea related to orthodeoxia caused by true vascular lung shunts. N Engl J Med 1976; 294: 941–3.
13. Alizadeh AHM, Fatemi SR, Mirzaee V et al. Clinical features of hepatopulmonary syndrome in cirrhotic patients. World J Gastroenterol 2006; 12: 1954–6.
14. Andrivet P, Cadranel J, Housset B et al. Mechanisms of impaired arterial oxygenation in patients with liver cirrhosis and severe respiratory insufficiency. Effects of indomethacin. Chest 1993; 103: 500–7.
15. Lima BLG, Franca AVC, Pazin-Filho A et al. Frequency, clinical characteristics, and respiratory parameters of hepatopulmonary syndrome. Mayo Clin Proc 2004; 79: 42–8.
16. Rodriguez-Roisin R, Roca J, Agusti AG et al. Gas exchange and pulmonary vascular reactivity in patients with liver cirrhosis. Am Rev Respir Dis 1987; 135: 1085–92.
17. Schenk P, Schöniger-Hekele M, Fuhrmann V et al. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. Gastroenterology 2003; 125: 1042–52.
18. Krowka MJ, Dickson ER, Cortese DA. Hepatopulmonary syndrome. Clinical observations and lack of therapeutic response to somatostatin analogue. Chest 1993; 104: 515–21.
19. Bruix J, Bosch J, Kravetz D et al. Effects of prostaglandin inhibition on systemic and hepatic hemodynamics in patients with cirrhosis of the liver. Gastroenterology 1985; 88: 430–5.
20. Krowka MJ, Cortese DA. Hepatopulmonary syndrome: an evolving perspective in the era of liver transplantation. Hepatology 1990; 11: 138–42.
21. Pizcueta P, Pique JM, Fernandez M et al. Modulation of the hyperdynamic circulation of cirrhotic rats by nitric oxide inhibition. Gastroenterology 1992; 103: 1909–15.
22. Cremona G, Higenbottam TW, Mayoral V et al. Elevated exhaled nitric oxide in patients with hepatopulmonary syndrome. Eur Respir J 1995; 8: 1883–5.
23. Rolla G, Brussino L, Colagrande P et al. Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 1997; 26: 842–7.
24. Fallon MB, Abrams GA. Pulmonary dysfunction in chronic liver disease. Hepatology 2000; 32: 859–65.
25. Nunes H, Lebrec D, Mazmanian M et al. Role of nitric oxide in hepatopulmonary syndrome in cirrhotic rats. Am J Respir Crit Care Med 2001; 164: 879–85.
26. Brussino L, Bucca C, Morello M et al. Effect on dyspnoea and hypoxemia of inhaled NG-nitro-L-arginine methyl ester in hepatopulmonary syndrome. Lancet 2003; 362: 43–4.
27. Schenk P, Madl C, Rezaie-Majid S et al. Methylene blue improves the hepatopulmonary syndrome. Ann Intern Med 2000; 133: 701–6.
28. Zhang HY, Han DW, Wang XG et al. Experimental study on the role of endotoxin in the development of hepatopulmonary syndrome. World J Gastroenterol 2005; 11: 567–72.
29. Rabiller A, Nunes H, Lebrec D et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med 2002; 166: 514–7.
30. Henriksen JH, Staun-Olsen P, Fahrenkrug P et al. Vasoactive intestinal polypeptide (VIP) in cirrhosis: arteriovenous extraction in different vascular beds. Scand J Gastroenterol 1980; 15: 787–92.
31. Hortnagl H, Singer EA, Lenz K et al. Substance-P is markedly increased in plasma of patients with hepatic coma. Lancet 1984; 1: 480–3.
32. Gines P, Jimenez W, Arroyo V et al. Atrial natriuretic factor in cirrhosis with ascites: Plasma levels, cardiac release and splanchnic extraction. Hepatology 1988; 8: 636–42.
33. Gómez FP, Barberà JA, Roca J et al. Effects of nebulized N(G)-nitro-L-arginine methyl ester in patients with hepatopulmonary syndrome. Hepatology 2006; 43: 1084–91.
34. Dinh-Xuan AT, Naeije R. The hepatopulmonary syndrome: NO way out? Eur Respir J 2004; 23: 661–2.
35. Davis HH, 2nd, Schwartz DJ, Lefrak SS et al. Alveolar-capillary oxygen disequilibrium in hepatic cirrhosis. Chest 1978; 73: 507–11.
36. Edell ES, Cortese DA, Krowka MJ et al. Severe hypoxemia and liver disease. Am Rev Respir Dis 1989; 140: 1631–5.
37. Rydell R, Hoffbauer FW. Multiple pulmonary arteriovenous fistulas in juvenile cirrhosis. Am J Med 1956; 21: 450–60.
38. Berthelot P, Walker JG, Sherlock S et al. Arterial changes in the lungs in cirrhosis of the liver – lung spider nevi. N Engl J Med 1966; 274: 291–8.
39. Robin ED, Horn B, Goris ML et al. Detection, quantitation and pathophysiology of lung spiders. Trans Assoc Am Physicians 1975; 88: 202–16.
40. Genovesi MG, Tierney DF, Taplin GV et al. An intravenous radio-nuclide method to evaluate hypoxemia caused by abnormal alveolar vessels. Limitation of conventional techniques. Am Rev Respir Dis 1976; 114: 59–65.
41. Wolfe JD, Tashkin DP, Holly FE et al. Hypoxemia of cirrhosis: detection of abnormal small pulmonary vascular channels by a quantitative radionuclide method. Am J Med 1977; 63: 746–54.
42. Williams A, Trewby P, Williams R et al. Structural alterations to the pulmonary circulation in fulminant hepatic failure. Thorax 1979; 34: 447–53.
43. Gotway MB, Dotson RH, Dawn SK. Hypoxemia in a patient with end-stage liver disease. Clin Pulm Med 2005; 12: 61–6.
44. Thorens JB, Junod AF. Hypoxemia and liver cirrhosis: a new argument in favour of a diffusion-perfusion defect. Eur Respir J 1992; 5: 754–6.
45. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
46. Schenk P, Fuhrmann V, Madl C et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 2002; 51: 853–9.
47. Rodriguez-Roisin R, Krowka MJ et al. ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 2004; 24: 861–80.
48. Offer J, Green L, Houghton AR, Campbell J. A case of hepatopulmonary syndrome. Echo Res Pract 2015; 2: K25–7.
49. Kamath PS. Portopulmonary hypertension and hepatopulmonary syndrome. J Gastroenterol Hepatol 2002; 17: S253–5.
50. Shub C, Tajik AJ, Seward JB et al. Detecting intrapulmonary right-to-left shunt with contrast echocardiography: observations in a patient with diffuse pulmonary arteriovenous fistulas. Mayo Clin Proc 1976; 51: 81–4.
51. Karabulut A, Iltumur K, Yalcin K et al. Hepatopulmonary syndrome and right ventricular diastolic functions: an echocardiographic examination. Echocardiography 2006; 23: 271–8.
52. Zamirian M, Aslani A, Shahrzad S. Left atrial volume: A novel predictor of hepatopulmonary syndrome. Am J Gastroenterol 2007; 102: 1392–6.
53. Wang YW, Lin HC. Recent advances in hepatopulmonary syndrome. J Chin Med Assoc 2005; 68: 500–5.
54. Abrams GA, Nanda NC, Dubovsky EV et al. The use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach. Gastroenterology 1998; 114: 305–10.
55. Ferreira MAP, Barreto SSM, Knorst MM et al. Semiquantitative echocardiographic evaluation of intrapulmonary vascular dilatations: correlation with evaluation of shunt levels and pulmonary function parameters. J Bras Pneumol 2009; 35: 106–13.
56. Scott VL, Dodson SF, Kang Y. The hepatopulmonary syndrome. Surg Clin North Am 1999; 79: 23–41.
57. Ryu JK, Oh JH. Hepatopulmonary syndrome: angiography and therapeutic embolization. Clin Imaging 2003; 27: 97–100.
58. Castro M, Krowka MJ. Hepatopulmonary syndrome: a pulmonary vascular complication of liver disease. Clin Chest Med 1996; 17: 35–48.
59. Saad NEA, Lee DE, Waldman DL et al. Pulmonary arterial coil embolization for the management of persistent Type 1 hepatopulmonary syndrome after liver transplantation. J Vasc Interv Radiol 2007; 18: 1576–80.
60. McAdams HP, Erasmus J, Crockett R, et al. The hepatopulmonary syndrome: radiologic findings in 10 patients. AJR Am J Roentgenol 1996; 166: 1379–85.
61. Lee KN, Lee HJ, Shin WW et al. Hypoxemia and liver cirrhosis (hepatopulmonary syndrome) in eight patients: comparison of the central and peripheral pulmonary vasculature. Radiology 1999; 211: 549–53.
62. Soderman C, Juhlin-Dannfelt A, Lagerstrand L et al. Ventilation-perfusion relationships and central haemodynamics in patients with cirrhosis. Effects of a somatostatin analogue. J Hepatol 1994; 21: 52–7.
63. Cadranel J, Milleron B, Cadranel JF et al. Severe hypoxemia associated intrapulmonary shunt in a patient with chronic liver disease: improvement after medical treatment. Am Rev Respir Dis 1992; 146: 526–7.
64. Milhe F, Reynaud-Gaubert M, Magnan A et al. Oxygenation improvement with almitrine bismesylate in the hepatopulmonary syndrome. Respiratory Medicine Extra 2006; 2: 81–4.
65. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
66. Nakos G, Evrenoglou D, Vassilakis N et al. Haemodynamics and gas exchange in liver cirrhosis: the effect of orally administered almitrine bimesylate. Respir Med 1993; 87: 93–8.
67. Rabiller A, Nunes H, Lebrec D et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med 2002; 166: 514–7.
68. Zhang J, Ling Y, Tang L et al. Pentoxifylline attenuation of experimental hepatopulmonary syndrome. J Appl Physiol 2007; 102: 949–55.
69. National Institutes of Health Pilot study of pentoxifylline for hepatopulmonary syndrome [online]: identifier: NCT00593658. 2008. http://clinicaltrials.gov/ct2/show/
NCT00593658?term=NCT00593658&rank=1
70. Krug S, Seyfarth HJ, Hagendorff A et al. Inhaled iloprost for hepatopulmonary syndrome: improvement of hypoxemia. Eur J Gastroenterol Hepatol 2007; 19: 1140–3.
71. Allgaier HP, Haag K, Ochs A et al. Hepatopulmonary syndrome: successful treatment by transjugular intrahepatic portosystemic stentshunt (TIPS). J Hepatol 1995; 23: 102–5.
72. Riegler JL, Lang KA, Johnson SP et al. Transjugular intrahepatic portosystemic shunt improves oxygenation in hepatopulmonary syndrome. Gastroenterology 1995; 109: 978–83.
73. Selim KM, Akriviadis EA, Zuckerman E et al. Transjugular intrahepatic portosystemic shunt: a successful treatment for hepatopulmonary syndrome. J Am Coll Gastroenterol 1998; 93: 455–8.
74. Martinez-Palli G, Drake BB, Garcia-Pagan JC et al. Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome. World J Gastroenterol 2005; 11: 6858–62.
75. Yamada R, Sato M, Kawabata M et al. Segmental obstruction of the hepatic inferior vena cava treated with transluminal angioplasty. Radiology 1983; 149: 91–6.
76. De BK, Sen S, Biswas PK et al. Occurrence of hepatopulmonary syndrome in Budd-Chiari syndrome and the role of venous decompression. Gastroenterology 2002; 122: 897–903.
77. White RE, Lynch-Nyhan A, Terry P et al. Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy. Radiology 1988; 169: 663–9.
78. Poterucha JJ, Krowka MJ, Dickson ER, et al. Failure of hepatopulmonary syndrome to resolve after liver transplantation and successful treatment with embolotherapy. Hepatology 1995; 21: 96–100.
79. Fukushima KY, Yatsuhashi H, Kinoshita A et аl. Two cases of hepatopulmonary syndrome with improved liver function following long-term oxygen therapy. J Gastroenterol 2007; 42: 176–80.
80. Krowka MJ, Mandell MS, Ramsay MA et al. Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database. Liver Transpl 2004; 10: 174–82.
81. Hoeper MM, Krowka MJ, Strassburg CP. Portopulmonary hypertension and hepatopulmonary syndrome. Lancet 2004; 363: 1461–8.
82. Lange PA, Stoller JK. Hepatopulmonary syndrome: effects of liver transplantation. Clin Chest Med 1996; 17: 115–23.
83. Arguedas M, Abrams GA, Krowka MJ et al. Prospective evaluation of outcomes and predictors of mortality in patients with hepatopulmonary syndrome undergoing liver transplantation. Hepatology 2003; 37: 192–7.
2. Stoller JK, Lange PA, Westveer MK et al. Prevalence and reversibility of the hepatopulmonary syndrome after liver transplantation – The Cleveland Clinic Experience. West J Med 1995; 163: 133–8.
3. Hopkins WE, Waggoner AD, Barzilai B. Frequency and significance of intrapulmonary right-to-left shunting in end-stage hepatic disease. Am J Cardiol 1992; 70: 516–9.
4. Swanson KL, Weiner RH, Krowka MJ. Natural history of hepatopulmonary syndrome: Impact of liver transplantation. Hepatology 2005; 41: 1122–9.
5. Grace JA, Angus PW. Hepatopulmonary Syndrome: Update on Recent Advances in Pathophysiology, Investigation, and Treatment. J Gastroenterol Hepatol 2013; 28: 213–9.
6. Nacif LS, Andraus W, Pinheiro RS et al. The hepatopulmonary syndrome. Arq Bras Cir Dig 2014; 27: 145–7.
7. Fluckiger M. Vorkommen von trommelschlägelförmigen finger-endphalengen ohne chronische veränderungen an der lungen oder am herzen. Wien Med Wschr 1884; 34: 1457.
8. Kennedy TC, Knudson RJ. Exercise-aggravated hypoxemia and orthodexia in cirrhosis. Chest 1997; 72: 305–9.
9. Abrams GA, Jaffe CC, Hoffer PB et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 1995; 109: 1283–8.
10. Seward JB, Hayes DL, Smith HC et al. Platypnea-orthodeoxia: clinical profile, diagnostic work-up, management and report of 7 cases. Mayo Clin Proc 1984; 59: 221–31.
11. Rolla G, Brussino L, Colagrande P et al. Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 1997; 26: 842–7.
12. Robin ED, Laman D, Horn BR et al. Platypnea related to orthodeoxia caused by true vascular lung shunts. N Engl J Med 1976; 294: 941–3.
13. Alizadeh AHM, Fatemi SR, Mirzaee V et al. Clinical features of hepatopulmonary syndrome in cirrhotic patients. World J Gastroenterol 2006; 12: 1954–6.
14. Andrivet P, Cadranel J, Housset B et al. Mechanisms of impaired arterial oxygenation in patients with liver cirrhosis and severe respiratory insufficiency. Effects of indomethacin. Chest 1993; 103: 500–7.
15. Lima BLG, Franca AVC, Pazin-Filho A et al. Frequency, clinical characteristics, and respiratory parameters of hepatopulmonary syndrome. Mayo Clin Proc 2004; 79: 42–8.
16. Rodriguez-Roisin R, Roca J, Agusti AG et al. Gas exchange and pulmonary vascular reactivity in patients with liver cirrhosis. Am Rev Respir Dis 1987; 135: 1085–92.
17. Schenk P, Schöniger-Hekele M, Fuhrmann V et al. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. Gastroenterology 2003; 125: 1042–52.
18. Krowka MJ, Dickson ER, Cortese DA. Hepatopulmonary syndrome. Clinical observations and lack of therapeutic response to somatostatin analogue. Chest 1993; 104: 515–21.
19. Bruix J, Bosch J, Kravetz D et al. Effects of prostaglandin inhibition on systemic and hepatic hemodynamics in patients with cirrhosis of the liver. Gastroenterology 1985; 88: 430–5.
20. Krowka MJ, Cortese DA. Hepatopulmonary syndrome: an evolving perspective in the era of liver transplantation. Hepatology 1990; 11: 138–42.
21. Pizcueta P, Pique JM, Fernandez M et al. Modulation of the hyperdynamic circulation of cirrhotic rats by nitric oxide inhibition. Gastroenterology 1992; 103: 1909–15.
22. Cremona G, Higenbottam TW, Mayoral V et al. Elevated exhaled nitric oxide in patients with hepatopulmonary syndrome. Eur Respir J 1995; 8: 1883–5.
23. Rolla G, Brussino L, Colagrande P et al. Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 1997; 26: 842–7.
24. Fallon MB, Abrams GA. Pulmonary dysfunction in chronic liver disease. Hepatology 2000; 32: 859–65.
25. Nunes H, Lebrec D, Mazmanian M et al. Role of nitric oxide in hepatopulmonary syndrome in cirrhotic rats. Am J Respir Crit Care Med 2001; 164: 879–85.
26. Brussino L, Bucca C, Morello M et al. Effect on dyspnoea and hypoxemia of inhaled NG-nitro-L-arginine methyl ester in hepatopulmonary syndrome. Lancet 2003; 362: 43–4.
27. Schenk P, Madl C, Rezaie-Majid S et al. Methylene blue improves the hepatopulmonary syndrome. Ann Intern Med 2000; 133: 701–6.
28. Zhang HY, Han DW, Wang XG et al. Experimental study on the role of endotoxin in the development of hepatopulmonary syndrome. World J Gastroenterol 2005; 11: 567–72.
29. Rabiller A, Nunes H, Lebrec D et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med 2002; 166: 514–7.
30. Henriksen JH, Staun-Olsen P, Fahrenkrug P et al. Vasoactive intestinal polypeptide (VIP) in cirrhosis: arteriovenous extraction in different vascular beds. Scand J Gastroenterol 1980; 15: 787–92.
31. Hortnagl H, Singer EA, Lenz K et al. Substance-P is markedly increased in plasma of patients with hepatic coma. Lancet 1984; 1: 480–3.
32. Gines P, Jimenez W, Arroyo V et al. Atrial natriuretic factor in cirrhosis with ascites: Plasma levels, cardiac release and splanchnic extraction. Hepatology 1988; 8: 636–42.
33. Gómez FP, Barberà JA, Roca J et al. Effects of nebulized N(G)-nitro-L-arginine methyl ester in patients with hepatopulmonary syndrome. Hepatology 2006; 43: 1084–91.
34. Dinh-Xuan AT, Naeije R. The hepatopulmonary syndrome: NO way out? Eur Respir J 2004; 23: 661–2.
35. Davis HH, 2nd, Schwartz DJ, Lefrak SS et al. Alveolar-capillary oxygen disequilibrium in hepatic cirrhosis. Chest 1978; 73: 507–11.
36. Edell ES, Cortese DA, Krowka MJ et al. Severe hypoxemia and liver disease. Am Rev Respir Dis 1989; 140: 1631–5.
37. Rydell R, Hoffbauer FW. Multiple pulmonary arteriovenous fistulas in juvenile cirrhosis. Am J Med 1956; 21: 450–60.
38. Berthelot P, Walker JG, Sherlock S et al. Arterial changes in the lungs in cirrhosis of the liver – lung spider nevi. N Engl J Med 1966; 274: 291–8.
39. Robin ED, Horn B, Goris ML et al. Detection, quantitation and pathophysiology of lung spiders. Trans Assoc Am Physicians 1975; 88: 202–16.
40. Genovesi MG, Tierney DF, Taplin GV et al. An intravenous radio-nuclide method to evaluate hypoxemia caused by abnormal alveolar vessels. Limitation of conventional techniques. Am Rev Respir Dis 1976; 114: 59–65.
41. Wolfe JD, Tashkin DP, Holly FE et al. Hypoxemia of cirrhosis: detection of abnormal small pulmonary vascular channels by a quantitative radionuclide method. Am J Med 1977; 63: 746–54.
42. Williams A, Trewby P, Williams R et al. Structural alterations to the pulmonary circulation in fulminant hepatic failure. Thorax 1979; 34: 447–53.
43. Gotway MB, Dotson RH, Dawn SK. Hypoxemia in a patient with end-stage liver disease. Clin Pulm Med 2005; 12: 61–6.
44. Thorens JB, Junod AF. Hypoxemia and liver cirrhosis: a new argument in favour of a diffusion-perfusion defect. Eur Respir J 1992; 5: 754–6.
45. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
46. Schenk P, Fuhrmann V, Madl C et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 2002; 51: 853–9.
47. Rodriguez-Roisin R, Krowka MJ et al. ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 2004; 24: 861–80.
48. Offer J, Green L, Houghton AR, Campbell J. A case of hepatopulmonary syndrome. Echo Res Pract 2015; 2: K25–7.
49. Kamath PS. Portopulmonary hypertension and hepatopulmonary syndrome. J Gastroenterol Hepatol 2002; 17: S253–5.
50. Shub C, Tajik AJ, Seward JB et al. Detecting intrapulmonary right-to-left shunt with contrast echocardiography: observations in a patient with diffuse pulmonary arteriovenous fistulas. Mayo Clin Proc 1976; 51: 81–4.
51. Karabulut A, Iltumur K, Yalcin K et al. Hepatopulmonary syndrome and right ventricular diastolic functions: an echocardiographic examination. Echocardiography 2006; 23: 271–8.
52. Zamirian M, Aslani A, Shahrzad S. Left atrial volume: A novel predictor of hepatopulmonary syndrome. Am J Gastroenterol 2007; 102: 1392–6.
53. Wang YW, Lin HC. Recent advances in hepatopulmonary syndrome. J Chin Med Assoc 2005; 68: 500–5.
54. Abrams GA, Nanda NC, Dubovsky EV et al. The use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach. Gastroenterology 1998; 114: 305–10.
55. Ferreira MAP, Barreto SSM, Knorst MM et al. Semiquantitative echocardiographic evaluation of intrapulmonary vascular dilatations: correlation with evaluation of shunt levels and pulmonary function parameters. J Bras Pneumol 2009; 35: 106–13.
56. Scott VL, Dodson SF, Kang Y. The hepatopulmonary syndrome. Surg Clin North Am 1999; 79: 23–41.
57. Ryu JK, Oh JH. Hepatopulmonary syndrome: angiography and therapeutic embolization. Clin Imaging 2003; 27: 97–100.
58. Castro M, Krowka MJ. Hepatopulmonary syndrome: a pulmonary vascular complication of liver disease. Clin Chest Med 1996; 17: 35–48.
59. Saad NEA, Lee DE, Waldman DL et al. Pulmonary arterial coil embolization for the management of persistent Type 1 hepatopulmonary syndrome after liver transplantation. J Vasc Interv Radiol 2007; 18: 1576–80.
60. McAdams HP, Erasmus J, Crockett R, et al. The hepatopulmonary syndrome: radiologic findings in 10 patients. AJR Am J Roentgenol 1996; 166: 1379–85.
61. Lee KN, Lee HJ, Shin WW et al. Hypoxemia and liver cirrhosis (hepatopulmonary syndrome) in eight patients: comparison of the central and peripheral pulmonary vasculature. Radiology 1999; 211: 549–53.
62. Soderman C, Juhlin-Dannfelt A, Lagerstrand L et al. Ventilation-perfusion relationships and central haemodynamics in patients with cirrhosis. Effects of a somatostatin analogue. J Hepatol 1994; 21: 52–7.
63. Cadranel J, Milleron B, Cadranel JF et al. Severe hypoxemia associated intrapulmonary shunt in a patient with chronic liver disease: improvement after medical treatment. Am Rev Respir Dis 1992; 146: 526–7.
64. Milhe F, Reynaud-Gaubert M, Magnan A et al. Oxygenation improvement with almitrine bismesylate in the hepatopulmonary syndrome. Respiratory Medicine Extra 2006; 2: 81–4.
65. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
66. Nakos G, Evrenoglou D, Vassilakis N et al. Haemodynamics and gas exchange in liver cirrhosis: the effect of orally administered almitrine bimesylate. Respir Med 1993; 87: 93–8.
67. Rabiller A, Nunes H, Lebrec D et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med 2002; 166: 514–7.
68. Zhang J, Ling Y, Tang L et al. Pentoxifylline attenuation of experimental hepatopulmonary syndrome. J Appl Physiol 2007; 102: 949–55.
69. National Institutes of Health Pilot study of pentoxifylline for hepatopulmonary syndrome [online]: identifier: NCT00593658. 2008. http://clinicaltrials.gov/ct2/show/
NCT00593658?term=NCT00593658&rank=1
70. Krug S, Seyfarth HJ, Hagendorff A et al. Inhaled iloprost for hepatopulmonary syndrome: improvement of hypoxemia. Eur J Gastroenterol Hepatol 2007; 19: 1140–3.
71. Allgaier HP, Haag K, Ochs A et al. Hepatopulmonary syndrome: successful treatment by transjugular intrahepatic portosystemic stentshunt (TIPS). J Hepatol 1995; 23: 102–5.
72. Riegler JL, Lang KA, Johnson SP et al. Transjugular intrahepatic portosystemic shunt improves oxygenation in hepatopulmonary syndrome. Gastroenterology 1995; 109: 978–83.
73. Selim KM, Akriviadis EA, Zuckerman E et al. Transjugular intrahepatic portosystemic shunt: a successful treatment for hepatopulmonary syndrome. J Am Coll Gastroenterol 1998; 93: 455–8.
74. Martinez-Palli G, Drake BB, Garcia-Pagan JC et al. Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome. World J Gastroenterol 2005; 11: 6858–62.
75. Yamada R, Sato M, Kawabata M et al. Segmental obstruction of the hepatic inferior vena cava treated with transluminal angioplasty. Radiology 1983; 149: 91–6.
76. De BK, Sen S, Biswas PK et al. Occurrence of hepatopulmonary syndrome in Budd-Chiari syndrome and the role of venous decompression. Gastroenterology 2002; 122: 897–903.
77. White RE, Lynch-Nyhan A, Terry P et al. Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy. Radiology 1988; 169: 663–9.
78. Poterucha JJ, Krowka MJ, Dickson ER, et al. Failure of hepatopulmonary syndrome to resolve after liver transplantation and successful treatment with embolotherapy. Hepatology 1995; 21: 96–100.
79. Fukushima KY, Yatsuhashi H, Kinoshita A et аl. Two cases of hepatopulmonary syndrome with improved liver function following long-term oxygen therapy. J Gastroenterol 2007; 42: 176–80.
80. Krowka MJ, Mandell MS, Ramsay MA et al. Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database. Liver Transpl 2004; 10: 174–82.
81. Hoeper MM, Krowka MJ, Strassburg CP. Portopulmonary hypertension and hepatopulmonary syndrome. Lancet 2004; 363: 1461–8.
82. Lange PA, Stoller JK. Hepatopulmonary syndrome: effects of liver transplantation. Clin Chest Med 1996; 17: 115–23.
83. Arguedas M, Abrams GA, Krowka MJ et al. Prospective evaluation of outcomes and predictors of mortality in patients with hepatopulmonary syndrome undergoing liver transplantation. Hepatology 2003; 37: 192–7.
________________________________________________
2. Stoller JK, Lange PA, Westveer MK et al. Prevalence and reversibility of the hepatopulmonary syndrome after liver transplantation – The Cleveland Clinic Experience. West J Med 1995; 163: 133–8.
3. Hopkins WE, Waggoner AD, Barzilai B. Frequency and significance of intrapulmonary right-to-left shunting in end-stage hepatic disease. Am J Cardiol 1992; 70: 516–9.
4. Swanson KL, Weiner RH, Krowka MJ. Natural history of hepatopulmonary syndrome: Impact of liver transplantation. Hepatology 2005; 41: 1122–9.
5. Grace JA, Angus PW. Hepatopulmonary Syndrome: Update on Recent Advances in Pathophysiology, Investigation, and Treatment. J Gastroenterol Hepatol 2013; 28: 213–9.
6. Nacif LS, Andraus W, Pinheiro RS et al. The hepatopulmonary syndrome. Arq Bras Cir Dig 2014; 27: 145–7.
7. Fluckiger M. Vorkommen von trommelschlägelförmigen finger-endphalengen ohne chronische veränderungen an der lungen oder am herzen. Wien Med Wschr 1884; 34: 1457.
8. Kennedy TC, Knudson RJ. Exercise-aggravated hypoxemia and orthodexia in cirrhosis. Chest 1997; 72: 305–9.
9. Abrams GA, Jaffe CC, Hoffer PB et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 1995; 109: 1283–8.
10. Seward JB, Hayes DL, Smith HC et al. Platypnea-orthodeoxia: clinical profile, diagnostic work-up, management and report of 7 cases. Mayo Clin Proc 1984; 59: 221–31.
11. Rolla G, Brussino L, Colagrande P et al. Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 1997; 26: 842–7.
12. Robin ED, Laman D, Horn BR et al. Platypnea related to orthodeoxia caused by true vascular lung shunts. N Engl J Med 1976; 294: 941–3.
13. Alizadeh AHM, Fatemi SR, Mirzaee V et al. Clinical features of hepatopulmonary syndrome in cirrhotic patients. World J Gastroenterol 2006; 12: 1954–6.
14. Andrivet P, Cadranel J, Housset B et al. Mechanisms of impaired arterial oxygenation in patients with liver cirrhosis and severe respiratory insufficiency. Effects of indomethacin. Chest 1993; 103: 500–7.
15. Lima BLG, Franca AVC, Pazin-Filho A et al. Frequency, clinical characteristics, and respiratory parameters of hepatopulmonary syndrome. Mayo Clin Proc 2004; 79: 42–8.
16. Rodriguez-Roisin R, Roca J, Agusti AG et al. Gas exchange and pulmonary vascular reactivity in patients with liver cirrhosis. Am Rev Respir Dis 1987; 135: 1085–92.
17. Schenk P, Schöniger-Hekele M, Fuhrmann V et al. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. Gastroenterology 2003; 125: 1042–52.
18. Krowka MJ, Dickson ER, Cortese DA. Hepatopulmonary syndrome. Clinical observations and lack of therapeutic response to somatostatin analogue. Chest 1993; 104: 515–21.
19. Bruix J, Bosch J, Kravetz D et al. Effects of prostaglandin inhibition on systemic and hepatic hemodynamics in patients with cirrhosis of the liver. Gastroenterology 1985; 88: 430–5.
20. Krowka MJ, Cortese DA. Hepatopulmonary syndrome: an evolving perspective in the era of liver transplantation. Hepatology 1990; 11: 138–42.
21. Pizcueta P, Pique JM, Fernandez M et al. Modulation of the hyperdynamic circulation of cirrhotic rats by nitric oxide inhibition. Gastroenterology 1992; 103: 1909–15.
22. Cremona G, Higenbottam TW, Mayoral V et al. Elevated exhaled nitric oxide in patients with hepatopulmonary syndrome. Eur Respir J 1995; 8: 1883–5.
23. Rolla G, Brussino L, Colagrande P et al. Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology 1997; 26: 842–7.
24. Fallon MB, Abrams GA. Pulmonary dysfunction in chronic liver disease. Hepatology 2000; 32: 859–65.
25. Nunes H, Lebrec D, Mazmanian M et al. Role of nitric oxide in hepatopulmonary syndrome in cirrhotic rats. Am J Respir Crit Care Med 2001; 164: 879–85.
26. Brussino L, Bucca C, Morello M et al. Effect on dyspnoea and hypoxemia of inhaled NG-nitro-L-arginine methyl ester in hepatopulmonary syndrome. Lancet 2003; 362: 43–4.
27. Schenk P, Madl C, Rezaie-Majid S et al. Methylene blue improves the hepatopulmonary syndrome. Ann Intern Med 2000; 133: 701–6.
28. Zhang HY, Han DW, Wang XG et al. Experimental study on the role of endotoxin in the development of hepatopulmonary syndrome. World J Gastroenterol 2005; 11: 567–72.
29. Rabiller A, Nunes H, Lebrec D et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med 2002; 166: 514–7.
30. Henriksen JH, Staun-Olsen P, Fahrenkrug P et al. Vasoactive intestinal polypeptide (VIP) in cirrhosis: arteriovenous extraction in different vascular beds. Scand J Gastroenterol 1980; 15: 787–92.
31. Hortnagl H, Singer EA, Lenz K et al. Substance-P is markedly increased in plasma of patients with hepatic coma. Lancet 1984; 1: 480–3.
32. Gines P, Jimenez W, Arroyo V et al. Atrial natriuretic factor in cirrhosis with ascites: Plasma levels, cardiac release and splanchnic extraction. Hepatology 1988; 8: 636–42.
33. Gómez FP, Barberà JA, Roca J et al. Effects of nebulized N(G)-nitro-L-arginine methyl ester in patients with hepatopulmonary syndrome. Hepatology 2006; 43: 1084–91.
34. Dinh-Xuan AT, Naeije R. The hepatopulmonary syndrome: NO way out? Eur Respir J 2004; 23: 661–2.
35. Davis HH, 2nd, Schwartz DJ, Lefrak SS et al. Alveolar-capillary oxygen disequilibrium in hepatic cirrhosis. Chest 1978; 73: 507–11.
36. Edell ES, Cortese DA, Krowka MJ et al. Severe hypoxemia and liver disease. Am Rev Respir Dis 1989; 140: 1631–5.
37. Rydell R, Hoffbauer FW. Multiple pulmonary arteriovenous fistulas in juvenile cirrhosis. Am J Med 1956; 21: 450–60.
38. Berthelot P, Walker JG, Sherlock S et al. Arterial changes in the lungs in cirrhosis of the liver – lung spider nevi. N Engl J Med 1966; 274: 291–8.
39. Robin ED, Horn B, Goris ML et al. Detection, quantitation and pathophysiology of lung spiders. Trans Assoc Am Physicians 1975; 88: 202–16.
40. Genovesi MG, Tierney DF, Taplin GV et al. An intravenous radio-nuclide method to evaluate hypoxemia caused by abnormal alveolar vessels. Limitation of conventional techniques. Am Rev Respir Dis 1976; 114: 59–65.
41. Wolfe JD, Tashkin DP, Holly FE et al. Hypoxemia of cirrhosis: detection of abnormal small pulmonary vascular channels by a quantitative radionuclide method. Am J Med 1977; 63: 746–54.
42. Williams A, Trewby P, Williams R et al. Structural alterations to the pulmonary circulation in fulminant hepatic failure. Thorax 1979; 34: 447–53.
43. Gotway MB, Dotson RH, Dawn SK. Hypoxemia in a patient with end-stage liver disease. Clin Pulm Med 2005; 12: 61–6.
44. Thorens JB, Junod AF. Hypoxemia and liver cirrhosis: a new argument in favour of a diffusion-perfusion defect. Eur Respir J 1992; 5: 754–6.
45. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
46. Schenk P, Fuhrmann V, Madl C et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 2002; 51: 853–9.
47. Rodriguez-Roisin R, Krowka MJ et al. ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J 2004; 24: 861–80.
48. Offer J, Green L, Houghton AR, Campbell J. A case of hepatopulmonary syndrome. Echo Res Pract 2015; 2: K25–7.
49. Kamath PS. Portopulmonary hypertension and hepatopulmonary syndrome. J Gastroenterol Hepatol 2002; 17: S253–5.
50. Shub C, Tajik AJ, Seward JB et al. Detecting intrapulmonary right-to-left shunt with contrast echocardiography: observations in a patient with diffuse pulmonary arteriovenous fistulas. Mayo Clin Proc 1976; 51: 81–4.
51. Karabulut A, Iltumur K, Yalcin K et al. Hepatopulmonary syndrome and right ventricular diastolic functions: an echocardiographic examination. Echocardiography 2006; 23: 271–8.
52. Zamirian M, Aslani A, Shahrzad S. Left atrial volume: A novel predictor of hepatopulmonary syndrome. Am J Gastroenterol 2007; 102: 1392–6.
53. Wang YW, Lin HC. Recent advances in hepatopulmonary syndrome. J Chin Med Assoc 2005; 68: 500–5.
54. Abrams GA, Nanda NC, Dubovsky EV et al. The use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach. Gastroenterology 1998; 114: 305–10.
55. Ferreira MAP, Barreto SSM, Knorst MM et al. Semiquantitative echocardiographic evaluation of intrapulmonary vascular dilatations: correlation with evaluation of shunt levels and pulmonary function parameters. J Bras Pneumol 2009; 35: 106–13.
56. Scott VL, Dodson SF, Kang Y. The hepatopulmonary syndrome. Surg Clin North Am 1999; 79: 23–41.
57. Ryu JK, Oh JH. Hepatopulmonary syndrome: angiography and therapeutic embolization. Clin Imaging 2003; 27: 97–100.
58. Castro M, Krowka MJ. Hepatopulmonary syndrome: a pulmonary vascular complication of liver disease. Clin Chest Med 1996; 17: 35–48.
59. Saad NEA, Lee DE, Waldman DL et al. Pulmonary arterial coil embolization for the management of persistent Type 1 hepatopulmonary syndrome after liver transplantation. J Vasc Interv Radiol 2007; 18: 1576–80.
60. McAdams HP, Erasmus J, Crockett R, et al. The hepatopulmonary syndrome: radiologic findings in 10 patients. AJR Am J Roentgenol 1996; 166: 1379–85.
61. Lee KN, Lee HJ, Shin WW et al. Hypoxemia and liver cirrhosis (hepatopulmonary syndrome) in eight patients: comparison of the central and peripheral pulmonary vasculature. Radiology 1999; 211: 549–53.
62. Soderman C, Juhlin-Dannfelt A, Lagerstrand L et al. Ventilation-perfusion relationships and central haemodynamics in patients with cirrhosis. Effects of a somatostatin analogue. J Hepatol 1994; 21: 52–7.
63. Cadranel J, Milleron B, Cadranel JF et al. Severe hypoxemia associated intrapulmonary shunt in a patient with chronic liver disease: improvement after medical treatment. Am Rev Respir Dis 1992; 146: 526–7.
64. Milhe F, Reynaud-Gaubert M, Magnan A et al. Oxygenation improvement with almitrine bismesylate in the hepatopulmonary syndrome. Respiratory Medicine Extra 2006; 2: 81–4.
65. Krowka MJ, Cortese DA. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use of almitrine bimesylate. Mayo Clin Proc 1987; 62: 164–73.
66. Nakos G, Evrenoglou D, Vassilakis N et al. Haemodynamics and gas exchange in liver cirrhosis: the effect of orally administered almitrine bimesylate. Respir Med 1993; 87: 93–8.
67. Rabiller A, Nunes H, Lebrec D et al. Prevention of gram-negative translocation reduces the severity of hepatopulmonary syndrome. Am J Respir Crit Care Med 2002; 166: 514–7.
68. Zhang J, Ling Y, Tang L et al. Pentoxifylline attenuation of experimental hepatopulmonary syndrome. J Appl Physiol 2007; 102: 949–55.
69. National Institutes of Health Pilot study of pentoxifylline for hepatopulmonary syndrome [online]: identifier: NCT00593658. 2008. http://clinicaltrials.gov/ct2/show/
NCT00593658?term=NCT00593658&rank=1
70. Krug S, Seyfarth HJ, Hagendorff A et al. Inhaled iloprost for hepatopulmonary syndrome: improvement of hypoxemia. Eur J Gastroenterol Hepatol 2007; 19: 1140–3.
71. Allgaier HP, Haag K, Ochs A et al. Hepatopulmonary syndrome: successful treatment by transjugular intrahepatic portosystemic stentshunt (TIPS). J Hepatol 1995; 23: 102–5.
72. Riegler JL, Lang KA, Johnson SP et al. Transjugular intrahepatic portosystemic shunt improves oxygenation in hepatopulmonary syndrome. Gastroenterology 1995; 109: 978–83.
73. Selim KM, Akriviadis EA, Zuckerman E et al. Transjugular intrahepatic portosystemic shunt: a successful treatment for hepatopulmonary syndrome. J Am Coll Gastroenterol 1998; 93: 455–8.
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Авторы
С.Н.Авдеев
ФГБУ НИИ пульмонологии ФМБА России. 105077, Россия, Москва, ул. 11-я Парковая, д. 32
serg_avdeev@list.ru
ФГБУ НИИ пульмонологии ФМБА России. 105077, Россия, Москва, ул. 11-я Парковая, д. 32
serg_avdeev@list.ru
________________________________________________
S.N.Avdeev
Scientific-Research Institute of Pulmonology. 105077, Russian Federation, Moscow, ul. 11-ia Parkovaia, d. 32
serg_avdeev@list.ru
Scientific-Research Institute of Pulmonology. 105077, Russian Federation, Moscow, ul. 11-ia Parkovaia, d. 32
serg_avdeev@list.ru
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