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Hepatopulmonary Syndrome (HPS) 

HPS-differential diagnosis:
1. Pulmonary vasculature
2. Diseases of the lung parenchyma
3. Pleura and diaphragm

HPS-diagnosis:
1. Patients
Hepatopulmonary ... Diseases of the lung ... Alveolar-arterial ... oxygen gradient ... HPS-severity classification
Approach to the A-a Gradient
A-a gradient = PAO2 - PaO2
A-a gradient = [FiO2 x (Patm -
AVMs, Hepatopulmonary ... Embolism, Obstructive Lung ... , Interstitial Lung ... #alveolar #arterial ... #pulmonary #Hypoxia
Clinical Classification of Pulmonary Hypertension

1. Pulmonary arterial hypertension from pulmonary vasculopathy
Idiopathic pulmonary arterial hypertension
Heritable gene mutations
Clinical Classification ... Pulmonary arterial ... arterial hypertension ... and/or hypoxia ... Interstitial lung
Hypoxemic Respiratory Failure - Differential Diagnosis Framework
DECREASED INSPIRED OXYGEN
 • Low PATM Can decrease first part
: Interstitial lung ... direction leads to hypoxemia ... AVMs, hepatopulmonary ... shunting (eg, atrial ... Respiratory #Failure #hypoxia
Hepatopulmonary Syndrome - Diagnosis and Management Summary
A defect in arterial oxygenation due to a gas exchange
Hepatopulmonary ... absence of intrinsic lung ... passage • Arterial ... on radioactive lung ... 80mmHg or A-a gradient
Pulmonary Hypertension Groups - WHO Classification
Group I - Vascular remodeling of pulmonary arteries
 • Idiopathic, HIV,
Groups - WHO Classification ... arteries • Idiopathic ... III - Chronic lung ... disease causing hypoxemia ... PH Functional Classification
Acute Respiratory Distress Syndrome – ARDS: Clinical Cheat Sheet

An acute diffuse, inflammatory lung injury, leading to
injury, leading ... to increased pulmonary ... congestion with hypoxemia ... consistent with pulmonary ... detected on CT or CXR
Bronchiectasis - Summary

What?
• Bronchiectasis is derived from the Greek words bronckos meaning airway and ectasis meaning
Chronic cough • Hypoxia ... in the adjacent lung ... of the affected lung ... CT) • Broncho-arterial ... Sputum cultures growing
Hepatopulmonary Syndrome - Illness Script
HPS is a pulmonary disorder of chronic liver disease characterized by a
Hepatopulmonary ... leads to impaired arterial ... = increased Aa gradient ... presence in the lower lung ... portal HTN • Aa gradient