title: Screening of hepatopulmonary syndrome (HPS) with CEUS and pulse-oximetry in liver cirrhosis patients eligible for liver transplant.
abstract: OBJECTIVE
  The prevalence of hepatopulmonary syndrome (HPS) in the setting of cirrhosis ranges between 4%-47%. We aimed to detect a correlation between heart and lungs findings on contrast-enhanced ultrasound (CEUS)and pulse-oximetry, in order to early detect HPS and thus to improve patients referral to orthotopic liver transplantation(OLT).
  
  
  METHODS
  We considered at risk for HPS all patients with delayed left ventricle (LV) enhancement of the contrast agent,at least 3 systolic beats after it appears in the right ventricle(RV). We correlated CEUS results with pulse-oximetry findings,considering to have a positive HPS diagnosis in all patients with both CEUS findings and SaO2 95%.
  
  
  RESULTS
  From 186 patients diagnosed with liver cirrhosis, 56 patients (30.10%) had delayed LV enhancement of the contrast agent. Pulse-oximetry showed alterations, such as SaO2 95%and PaO2 70 mmHg in 62 patients (33.33%). Pearson index showed a good correlation between lung and heart CEUS findings and pulse-oximetry (r=0.99) in HPS diagnosis. CONCLUSIONS. Two non-invasive, simple and rapid methods such as CEUS and pulse-oximetry can easily diagnose HPS, a highly fatal complication of liver cirrhosis, and can also guide the future treatment by speeding up OLT recommendations.
authors.forename: A I
authors.initials: AI
authors.lastname: Suceveanu
authors.forename: L
authors.initials: L
authors.lastname: Mazilu
authors.forename: D
authors.initials: D
authors.lastname: Tomescu
authors.forename: N
authors.initials: N
authors.lastname: Ciufu
authors.forename: I R
authors.initials: IR
authors.lastname: Parepa
authors.forename: A P
authors.initials: AP
authors.lastname: Suceveanu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010092:Oximetry / Q000379:methods; D018579:Patient Selection; D015995:Prevalence; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media