Inhaled nitric oxide improves the hepatopulmonary syndrome: a physiologic analysis.

Abstract

The hepatopulmonary syndrome (HPS) is defined by liver dysfunction, intrapulmonary vasodilatation and abnormal oxygenation. Hypoxaemia is progressive and liver transplant is the only effective treatment. Severe hypoxaemia is a life-threatening HPS complication, particularly after transplant. We evaluated gas-exchange and haemodynamic effects of invasive therapies in a consecutive sample of 26 pre-transplant patients. Inhaled nitric oxide significantly improved partial pressure of oxygen (12.4 mm Hg; p=0.001) without deleterious effects on cardiac output. Trendelenburg positioning resulted in a small improvement, and methylene blue did not, though individual responses were variable. Future studies should prospectively evaluate these strategies in severe post-transplant hypoxaemia.

• Authors: Samir Gupta, Rosalind Tang, Abdul Al-Hesayen
• Journal: Thorax (Thorax) Vol. 76 Issue 11 Pg. 1142-1145 (11 2021) ISSN: 1468-3296 [Electronic] England
• PMID: 33859047 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Nitric Oxide
• Oxygen

Topics

• Hepatopulmonary Syndrome (drug therapy)
• Humans
• Hypoxia (drug therapy)
• Liver Transplantation
• Nitric Oxide
• Oxygen