title: [Platypnea-orthodeoxia syndrome: a rare cause of severe hypoxemia].
abstract: BACKGROUND
  The platypnea-orthodeoxia syndrome (PO) includes: (i) a dyspnea increasing with orthostatism and decreasing in supine position, (ii) wide positional range in arterial oxygen saturation with tachycardia, (iii) and hypoxemia refractory to oxygen therapy. This syndrome is usually related to a cardiac right-left shunt, and rarely to a pulmonary shunt.
  
  
  METHODS
  We report a case of a patient presenting with a post-lung infection dyspnea associated with severe hypoxemia and shunt effect at blood gas. Contrast-enhanced CT-scan showed no pulmonary embolism. PO syndrome was suspected given the transcutaneous blood oxygen saturation variation from 90% in supine position to 60% in standing position, tachycardia, and absence of response to the intensive oxygen therapy.
  
  
  CONCLUSIONS
  This syndrome should be known by physicians as a possible differential diagnose for refractory dyspnea to oxygen since effective treatment is available.
authors.affiliation: Service de médecine aiguë gériatrique, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France. Electronic address: aderoux@chu-grenoble.fr.
authors.forename: A
authors.initials: A
authors.lastname: Deroux
authors.affiliation: Service de médecine aiguë gériatrique, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: E
authors.initials: E
authors.lastname: Chidlovskii
authors.affiliation: Service de pneumologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Bosc
authors.affiliation: Service de pneumologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Pison
authors.affiliation: Clinique universitaire de médecine gériatrique, pôle pluridisciplinaire de médecine, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
authors.forename: P
authors.initials: P
authors.lastname: Couturier
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004417:Dyspnea / Q000209:etiology* / Q000628:therapy; D017809:Fatal Outcome; D054092:Foramen Ovale, Patent / Q000150:complications / Q000175:diagnosis; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000628:therapy; D008297:Male; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D016683:Supine Position; D013577:Syndrome; D013610:Tachycardia / Q000209:etiology / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D010100:Oxygen
keywords: Effet shunt; Hypoxémie réfractaire; Platypnea-orthodeoxia; Refractory hypoxemia; Shunt effect; Syndrome platypnée orthodéoxie