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Intrapulmonary arteriovenous shunt in children with chronic liver disease: clinical features, laboratory data and

Eftekhar Mahmoodi1, Hamid Reza Kianifar, Simin Partovi

  • 1Department of Pediatric Cardiology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|June 11, 2008
PubMed

Insights

Hepatopulmonary syndrome, characterized by intrapulmonary shunting, is a frequent complication in children with chronic liver disease. This condition is linked to physical symptoms and can predict mortality.

Area of Science:

  • Pediatric Gastroenterology
  • Pulmonology
  • Hepatology

Background:

  • Chronic liver disease (CLD) in children can lead to serious complications.
  • Hepatopulmonary syndrome (HPS) is a known complication of advanced liver disease.

Purpose of the Study:

  • To investigate the prevalence of hepatopulmonary syndrome in pediatric CLD patients.
  • To identify clinical and biochemical factors associated with HPS in this population.

Main Methods:

  • A cohort of 53 children with CLD was studied.
  • Contrast echocardiography with agitated saline was used to detect intrapulmonary shunting.
  • Arterial blood gases were measured.

Main Results:

  • 18 out of 53 children (34%) exhibited intrapulmonary shunting.
  • Shunting correlated with splenomegaly, cyanosis, and dyspnea.
  • Liver function tests did not correlate with shunting.
  • Hypoxemia (PaO2 < 70 mmHg) predicted mortality in patients with shunting.

Conclusions:

  • Intrapulmonary shunting is a significant and common complication in children with CLD.
  • HPS in pediatric CLD is associated with specific clinical signs and carries prognostic implications.
Abstract

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