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Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome

Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome

作     者:Graciela Martínez-Pallí Britt B Drake Joan-Carles García-Pagán Joan-Albert Barberà Miguel R Arguedas Robert Rodriguez-Roisin Jaume Bosch Michael B Fallon 

作者机构:Servei d'Anestesiologia i Reanimació. Hospital Clínic University of Alabama at Birmingham Liver Center Hepatic Hemodynamic Laboratory Servei de Pneumologia i Al.lèrgia Respiratòria 

出 版 物:《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文版))

年 卷 期:2005年第11卷第43期

页      面:6858-6862页

核心收录:

学科分类:1002[医学-临床医学] 10[医学] 

基  金:Supported by FIS 02/0692 and 02/0739 from the Fondo de In-vestigaciones Sanitarias  SGR 2001 SGR00286 from the Gener-alitat de Catalunya (DURSI)  and CO 3/02 and CO 3/11 from the Instituto de Salud Carlos Ⅲ 

主  题:颈静脉 门静脉 高血压 病理机制 

摘      要:AIM: To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome (HPS).METHODS: Seven patients, three of them with advanced HPS, in whom detailed pulmonary function tests were performed before and after TIPS placementat the University of Alabama Hospital and at the Hospital Clinic, Barcelona, were considered.RESULTS: TIPS patency was confirmed by hemodynamic evaluation. No changes in arterial blood gases were observed in the overall subset of patients. Transient arterial oxygenation improvement was observed in only one HPS patient, early after TIPS, but this was not sustained 4 mo later.CONCLUSION: TIPS neither improved nor worsened pulmonary gas exchange in patients with portal hypertension. This data does not support the use of TIPS as a specific treatment for HPS. However, it does reinforce the view that TIPS can be safely performed for the treatment of other complications of portal hypertension in patients with HPS.

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