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• W2884023415 abstract "Background and Aims: Hepatopulmonary syndrome (HPS) by is one of the most important causes of dyspnea in patients of CLD with reported prevalence ranging from 4-47%. Routine screening for HPS is not widely adopted despite prognostic and therapeutic implications of HPS, one of the reasons being cross-referencing with cardiologists. Screening for HPS can be done using pulse oximetry and arterial blood gas analysis. However, establishing the diagnosis of HPS requires demonstration of intrapulmonary shunting. Traditionally this is done using contrast-enhanced echocardiography. We present a novel endoscopic ultrasound guided method to detect HPS. Methods: 10 patients with child C cirrhosis who presented with complaints of dyspnea and evidence of deoxia (spO2 < 97%) were enrolled for the study. After sedation routine screening endoscopy was done followed by EUS. The left atrium was located at around 33 cm distance in the esophagus and the right atrium was visualized in the same plane. Once both chambers were placed in same axis in real time, 10 ml agitated saline was injected via a wide bore IV cannula. Cardiac cycles were monitored in real time EUS. The first appearance of bubbles in right atrium was taken as the index cycle. Detection of the microbubbles in left atrium after 3 cardiac cycles was considered as diagnostic of HPS. Results: Mean age of patients was 54 ± 3.56 yrs. Mean SpO2 and PaO2 values were 93.2 ± 0.61% and 70.71 ± 1.87 mmHg respectively. Using EUS intrapulmonary shunting could be documented in 7 patients. Total average duration for EUS procedure was 2.6 ± 0.22 min. No complications were noted during all 10 procedures. Conclusion: EUS guided detection of HPS is a safe, simple and quick procedure and should be widely adopted in evaluation of CLD patients who present with dyspnea. The authors have none to declare. Table 1 Comparison of shunt & no shunt group.Tabled 1Shunt GroupNo Shunt GroupP valuesDemography and status of liver diseaseNumber73–Age56.57 ± 3.7950 ± 8.020.10Sex distribution5 males, 2 females2 males, 1 femaleCTP score12.14 ± 0.5512.66 ± 0.320.17ALB2.2 ± 0.192.43 ± 0.080.08INR2.37 ± 0.222.33 ± 0.500.85Oxygenation ParametersSpO293.42 ± 0.8192.66 ± 0.880.22PaO271.14 ± 2.4869.7 ± 3.020.43 Open table in a new tab Table 2 Salient features of EUS guided HPS evaluation.Tabled 1First demonstration of EUS to evaluate HPSQuick, with average reported time ∼2.6 minsSafe, No adverse events noted during and after the procedureEndoscopic room examination, can be clubbed with screening UGI endoscopyCheaper, Saves cross consultationComparable Sensititivity and safety to available echocardiographiesEnables serial monitoring for HPS Open table in a new tab" @default.
• W2884023415 created "2018-08-03" @default.
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• W2884023415 date "2018-07-01" @default.
• W2884023415 modified "2023-09-30" @default.
• W2884023415 title "58. Endoscopic ultrasound (EUS) guided evaluation of hepatopulmonary syndrome" @default.
• W2884023415 doi "https://doi.org/10.1016/j.jceh.2018.06.419" @default.
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