Hepatopulmonary syndrome

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As Hepatopulmonary syndrome refers to a pathological decrease in lung function that can occur as a complication of severe liver failure.

root cause

One of the main functions of the liver is the breakdown of foreign and endogenous substances. In the case of the body's own substances, this breakdown is in a steady state in relation to their formation. Due to the failure of most of the liver function, vasodilating substances such as nitric oxide are also insufficiently removed from the bloodstream. This causes the lung capillaries to expand beyond normal. As a result, too much blood flows into the lungs compared to the oxygen supply. This is known as a ventilation perfusion mismatch.

Symptoms

Affected patients report shortness of breath , which worsens when standing. Hyperventilation can often be observed.

Diagnosis

A blood gas analysis while standing shows a decrease in the oxygen content of the blood below 70mmHG. A difference between the oxygen content of the arterial blood and the alveolar space indicates non-oxygenated blood in the pulmonary circulation. A lung perfusion scintigraphy is proof.

therapy

The shortage of breath can usually be remedied quickly and easily by administering 100% oxygen. To restore liver function, only liver transplantation has so far been available.

Medical history

The hepatopulmonary syndrome was defined as a separate disease in 1984.

Individual evidence

  1. ↑ a b c d e Herbert Renz-Polster , Steffen Krautzig, Jörg Braun (Eds.): Basic textbook internal medicine. 3. Edition. Munich, 2006, p. 681.

literature

  • V. Ho: Current concepts in the management of hepatopulmonary syndrome. In: Vascular health and risk management. Volume 4, number 5, 2008, pp. 1035-1041, PMID 19183751 , PMC 2605324 (free full text) (review).