Anesthesia for Patients with Concomitant Hepatic and Pulmonary Dysfunction.
Hepatic function and pulmonary function are interrelated with failure of one organ system affecting the other. With improved therapies, patients with concomitant hepatic and pulmonary failure increasingly enjoy a good quality of life and life expectancy. Therefore, the prevalence of such patients is increasing with more presenting for both emergent and elective surgical procedures. Hypoxemia requires a thorough evaluation in patients with end-stage liver disease. The most common etiologies respond to appropriate therapy. Portopulmonary hypertension and hepatopulmonary syndrome are associated with increased perioperative morbidity and mortality. It is incumbent on the anesthesiologist to understand the physiology of liver failure and its early effect on pulmonary function to ensure a successful outcome.
Department of Anesthesiology/Critical Care, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA. Electronic address: gdiaz@dacc.uchicago.edu.
Geraldine C
GC
Diaz
Department of Anesthesiology/Critical Care, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Michael F
MF
O'Connor
Department of Surgery, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
John F
JF
Renz
D000758:Anesthesia / Q000379:methods*; D003550:Cystic Fibrosis / Q000150:complications; D006331:Heart Diseases / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D020065:Hepatopulmonary Syndrome / Q000150:complications; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D000860:Hypoxia / Q000628:therapy; D008171:Lung Diseases / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications
Anesthesia; Cirrhosis; Hepatopulmonary syndrome; Intrapulmonary vascular dilatation; Portopulmonary hypertension