Das hepatopulmonale Syndrom - Wo stehen wir im Jahr 2006?
| Autor: | M. Essig, J. Reichen, J. M. Gschossmann, U. Scheurer, G. Gerken |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Gastroenterology Liver transplantation medicine.disease Hypoxemia Surgery Liver disease Internal medicine medicine Etiology Cardiology Pulmonary shunt medicine.symptom Complication business Hepatopulmonary syndrome Cardiopulmonary disease |
| Zdroj: | Zeitschrift für Gastroenterologie. 44:249-256 |
| ISSN: | 1439-7803 0044-2771 |
| DOI: | 10.1055/s-2005-858995 |
| Popis: | The hepato-pulmonary syndrome (HPS) is characterized by a combination of liver disease and pulmonary gas exchange abnormalities with arterial hypoxemia, intrapulmonary vasodilatation and arteriovenous shunting in the absence of intrinsic cardiopulmonary disease. The course of the disease is typically progressive. The mortality rate correlates with the pulmonary shunt volume and the degree of hypoxemia at room air. While the patho-physiology of HPS is still not fully understood, a multifactorial etiology is favored. Apart from functional intrapulmonary arteriovenous shunts which appear to represent a major factor in the development of HPS, both ventilation-perfusion mismatch and limited oxygen diffusion contribute to the HPS. Regarding its clinical appearance, pulmonary and hepatic symptoms have to be distinguished. Contrast echocardiography is the primary diagnostic tool. Symptomatically, hypoxemia can be treated with oxygen. So far, the only successful treatment approach which has been tested in larger patient groups, is liver transplantation. Given this background, the aim of this review is to critically discuss current concepts of this serious complication of liver diseases. |
| Databáze: | OpenAIRE |
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