A study of the prevalence of hepatopulmonary syndrome in chronic liver cirrhosis patients, and the various predictive cut-off values for arterial oxygenation and their clinical consequences

Background
Hepatopulmonary syndrome (HPS) distinguished by hypoxemia resulting from dilatation of the pulmonary vasculature. This study aimed to examine the prevalence and prognostic value of different arterial oxygenation thresholds among individuals diagnosed with chronic liver cirrhosis, with a particular emphasis on the HPS.


Method
A total of 100 individuals with probable HPS and liver cirrhosis participated in this descriptive cross-sectional investigation. Patients were categorized into two groups. Group I (HPS): positive agitated echocardiography. Group II (non-HPS): negative agitated echocardiography.


Results

Platypnea, cyanosis, and orthodeoxia were seen in group (I) with a significant statistical value (
P
=0.0001). On the other hand, orthopnea was discovered in 20 (21.5%) patients in group (II) but not in any patients in group (I), with a significant statistical value (
P
=0.005). Both the severity ofwaser disease as measured by the Child–Pugh scale (
P
=0.034) and the etiology of cirrhosis (
P
=0.038) were significantly different across the categories. In comparison to group II, group I had lower blood albumin and higher serum bilirubin levels on average. The two groups were significantly different from one another (
P
=0.025 and
P
=0.04, respectively). The average arterial oxygen partial pressure (PaO
2
) was lower in group I than in group II. On the other hand, group I had a significantly greater mean alveolar-arterial difference in oxygen partial pressure (AaDO
2
) than group II (
P
=0.008).



Conclusion
HPS prevalence among cirrhotic patients was low (7%). Arterial oxygenation thresholds, along with other clinical and laboratory markers, can serve as valuable prognostic indicators in patients with chronic liver cirrhosis, particularly in HPS.