title: Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome.
abstract: OBJECTIVE
  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 placement at 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Servei d'Anestesiologia i Reanimacio Hospital Clinic, Institut d'Investigacions Biomediques august Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Graciela
authors.initials: G
authors.lastname: Martinez-Palli
authors.forename: Britt B
authors.initials: BB
authors.lastname: Drake
authors.forename: Joan-Carles
authors.initials: JC
authors.lastname: Garcia-Pagan
authors.forename: Joan-Albert
authors.initials: JA
authors.lastname: Barbera
authors.forename: Miguel R
authors.initials: MR
authors.lastname: Arguedas
authors.forename: Robert
authors.initials: R
authors.lastname: Rodriguez-Roisin
authors.forename: Jaume
authors.initials: J
authors.lastname: Bosch
authors.forename: Michael B
authors.initials: MB
authors.lastname: Fallon
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006439:Hemodynamics; D020065:Hepatopulmonary Syndrome / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011659:Pulmonary Gas Exchange / Q000502:physiology*