Araştırma Makalesi
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Portabl Pulse Oxymetry and Contrast Echocardiography in Hepatopulmonary Syndrome Diagnosis

Yıl 2022, Cilt: 14 Sayı: 1, 16 - 19, 30.04.2022
https://doi.org/10.35514/mtd.2022.62

Öz

Objective : The aim of this study is investigating hepatopulmonary syndrome’s diagnosis in cirrhosis patients with ortodeoxy symptom by portabl pulse oxymetry and transthoracic echocardiography with contrast enhancement.

Material and method : Ninety five(95) patients(67/28 M/F ) with the diagnosis of cirrhosis were included into the study. Mean age of the patients was 52,28±12,0 . Measurements of portabl pulse oximetry were obtained in a supin position and in a seated position breathing room air. The suitable patients’ response to oxygen therapy with nasal cannula was evaluated.The patients with hypoxaemia(Sa,02<%94) in seated position were investigated HPS by transthoracic echocardiography with contrast enhancement .

Results: Eight(8) patients defined HPS had hypoxaemia in seated position with pulse oxymetry and positive contrast echocardiography.Four patients (4) had type I HPS and four patients(4) had type II HPS .

Conclusion: In conclusion , eight of 95(%8,4) patients had HPS . Patients with HPS were old age and were in Child B and C class.In cirrhosis patients with hypoxaemia in seated position , further studies are needed to investigate HPS .

Kaynakça

  • 1. Peter Schenk,Maximilian Schöniger-Hekele,Valentin Fuhrmann,Christian Madl,Gerd Silberhumer,Christian Müller. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. GASTROENTEROLOGY 2003;125:1042–1052.
  • 2. Offer J, Green L, Houghton AR, Campbell J. A case of hepatopulmonary syndrome. Echo Res Pract. 2015;2(2):K25-K27. doi:10.1530/ERP-14-0100
  • 3. Lenci I, Alvior A, Manzia TM, Toti L, Neuberger J, Steeds R. Saline contrast echocardiography in patients with hepatopulmonary syndrome awaiting liver transplantation. J Am Soc Echocardiogr. 2009 Jan;22(1):89-94. Cosarderelioglu C, Cosar AM, Gurakar M, Dagher NN, Gurakar A. Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature. J Clin Transl Hepatol. 2016;4(1):47-53.
  • 4. Lucas SoutoNacif,Erica Karen DextreTorres,Paola Sofia etal. Hepatopulmonary syndrome in waiting list and liver transplant. Transplantation Reports Volume 5, Issue 3, September 2020.
  • 5. Piltcher-da-Silva R, Chedid MF, Grezzana Filho TJM, et al. Severe hepatopulmonary syndrome with hypoxemia refractory to liver transplant: Recovery after 67 days of ECMO support. The International Journal of Artificial Organs. 2022;45(1):121-123. 6. Abrams GA et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 1995;109:1283–8.
  • 7. María J. Rollán, Ana C. Muñoz, Teresa Pérez, José L. Bratos, Value of contrast echocardiography for the diagnosis of hepatopulmonary syndrome, European Journal of Echocardiography, Volume 8, Issue 5, October 2007, Pages 408–410.
  • 8. Whyte MK et al.Analysis of intrapulmonary right to left shunt in the hepatopulmonary syndrome. J Hepatol 1998; 29: 85–93.
  • 9. Jensen DM, Pothamsetty S, Ganger D, et al., Clinical manifestations ofcirrhotic patients with intrapulmonary shunts. Gastroenterology 1994;106.
  • 10. Aller R et al. Diagnosis of hepatopulmonary syndrome with contrast transesophageal echocardiography: advantages over contrast transthoracic echocardiography.Dig Dis Sci 1999;44:1243–8.
  • 11. Schenk P et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 2002; 51: 853–859.
  • 12. Amir Houshang Mohammad Alizadeh et al. Clinical features of hepatopulmonary syndrome in cirrhotic patients. World J Gastroenterol 2006; 28: 1954-1956.
  • 13. Deibert P et al.Hepatopulmonary syndrome in patients with chronic liver disease : role of pulseoximetry. BMC Gastroenterology 2006; 6:15.
  • 14. Hopkins WE, Waggoner AD, Barzilai B. Frequency and significance of intrapulmonary right-to- left shunting in endstage hepatic disease. Am J Cardiol 1992; 70: 516–519.

Hepatopulmoner Sendrom Tanısında Portabl Pulse Oksimetre ve Kontrast Ekokardiyografi

Yıl 2022, Cilt: 14 Sayı: 1, 16 - 19, 30.04.2022
https://doi.org/10.35514/mtd.2022.62

Öz

Amaç : Bu çalışmanın amacı, ortodeoksi semptomu olan siroz hastalarında hepatopulmoner sendrom tanısının portabl pulse oksimetri ve kontrastlı transtorasik ekokardiyografi ile araştırılmasıdır.

Gereç ve yöntem : Çalışmaya siroz tanılı doksan beş(95) hasta(67/28 E/K) dahil edildi. Hastaların yaş ortalaması 52,28±12,0 idi. Portabl nabız oksimetresi ölçümleri, supin pozisyonunda ve oturma pozisyonunda oda havasını soluyarak elde edildi. Uygun hastaların nazal kanül ile oksijen tedavisine yanıtları değerlendirildi. Oturur pozisyonda hipoksemisi (Sa,02<%94) olan hastalarda kontrastlı transtorasik ekokardiyografi ile HPS incelendi.

Bulgular: HPS olarak tanımlanan sekiz(8) hastada nabız oksimetrisi ve pozitif kontrastlı ekokardiyografi ile oturur pozisyonda hipoksemi vardı. Dört hastada (4) tip I HPS ve dört hastada(4) tip II HPS vardı.

Sonuç: Sonuç olarak 95 (%8,4) hastanın sekizinde HPS vardı. HPS'li hastalar ileri yaştaydı ve Child B ve C sınıfındaydılar. Oturur pozisyonda hipoksemisi olan siroz hastalarında HPS'yi araştırmak için daha ileri çalışmalara ihtiyaç vardır.

Kaynakça

  • 1. Peter Schenk,Maximilian Schöniger-Hekele,Valentin Fuhrmann,Christian Madl,Gerd Silberhumer,Christian Müller. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. GASTROENTEROLOGY 2003;125:1042–1052.
  • 2. Offer J, Green L, Houghton AR, Campbell J. A case of hepatopulmonary syndrome. Echo Res Pract. 2015;2(2):K25-K27. doi:10.1530/ERP-14-0100
  • 3. Lenci I, Alvior A, Manzia TM, Toti L, Neuberger J, Steeds R. Saline contrast echocardiography in patients with hepatopulmonary syndrome awaiting liver transplantation. J Am Soc Echocardiogr. 2009 Jan;22(1):89-94. Cosarderelioglu C, Cosar AM, Gurakar M, Dagher NN, Gurakar A. Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature. J Clin Transl Hepatol. 2016;4(1):47-53.
  • 4. Lucas SoutoNacif,Erica Karen DextreTorres,Paola Sofia etal. Hepatopulmonary syndrome in waiting list and liver transplant. Transplantation Reports Volume 5, Issue 3, September 2020.
  • 5. Piltcher-da-Silva R, Chedid MF, Grezzana Filho TJM, et al. Severe hepatopulmonary syndrome with hypoxemia refractory to liver transplant: Recovery after 67 days of ECMO support. The International Journal of Artificial Organs. 2022;45(1):121-123. 6. Abrams GA et al. Diagnostic utility of contrast echocardiography and lung perfusion scan in patients with hepatopulmonary syndrome. Gastroenterology 1995;109:1283–8.
  • 7. María J. Rollán, Ana C. Muñoz, Teresa Pérez, José L. Bratos, Value of contrast echocardiography for the diagnosis of hepatopulmonary syndrome, European Journal of Echocardiography, Volume 8, Issue 5, October 2007, Pages 408–410.
  • 8. Whyte MK et al.Analysis of intrapulmonary right to left shunt in the hepatopulmonary syndrome. J Hepatol 1998; 29: 85–93.
  • 9. Jensen DM, Pothamsetty S, Ganger D, et al., Clinical manifestations ofcirrhotic patients with intrapulmonary shunts. Gastroenterology 1994;106.
  • 10. Aller R et al. Diagnosis of hepatopulmonary syndrome with contrast transesophageal echocardiography: advantages over contrast transthoracic echocardiography.Dig Dis Sci 1999;44:1243–8.
  • 11. Schenk P et al. Hepatopulmonary syndrome: prevalence and predictive value of various cut offs for arterial oxygenation and their clinical consequences. Gut 2002; 51: 853–859.
  • 12. Amir Houshang Mohammad Alizadeh et al. Clinical features of hepatopulmonary syndrome in cirrhotic patients. World J Gastroenterol 2006; 28: 1954-1956.
  • 13. Deibert P et al.Hepatopulmonary syndrome in patients with chronic liver disease : role of pulseoximetry. BMC Gastroenterology 2006; 6:15.
  • 14. Hopkins WE, Waggoner AD, Barzilai B. Frequency and significance of intrapulmonary right-to- left shunting in endstage hepatic disease. Am J Cardiol 1992; 70: 516–519.
Toplam 13 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Hüseyin Sancar Bozkurt 0000-0003-2097-2950

Yayımlanma Tarihi 30 Nisan 2022
Gönderilme Tarihi 16 Mart 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 14 Sayı: 1

Kaynak Göster

Vancouver Bozkurt HS. Portabl Pulse Oxymetry and Contrast Echocardiography in Hepatopulmonary Syndrome Diagnosis. Maltepe tıp derg. 2022;14(1):16-9.