Essay on Symptoms And Treatment Of Hepatopulmonary Syndrome
1051 Words Sep 7th, 2014 5 Pages
Hepatopulmonary syndrome (HPS) is most commonly developed from patients that have cirrhosis of the liver and/or portal hypertension (Kuntz, 2006). HPS is caused by intrapulmonary vascular dilation of the lungs and this is turn causes severe hypoxemia (Kuntz, 2006). The HPS pathophysiological pathway is complex and multifactorial (Kuntz, 2006). Cirrhosis is the most common cause of HPS, other pathways that leads to HRS is portal hypertension detailed also in the pathway for Heptarenal Syndrome (Kuntz, 2006).
Intrapulmonary arteriovenous dilations
The image shows in a) a representation of a normal gas exchange, the oxygen is diffusing into a pulmonary capillary from the alveolus b) is the gas exchange in HPS, showing the dilation of the intrapulmonary capillary vessels, this results in the reduction of oxygen from the alveolus and a reduced about of oxygenation of the blood (Grace, 2013). The dilation is increased by the accelerated blood flow and the presence of shunting due to direct arteriovenous communications (Grace, 2013). Fig 1. (Grace, 2013)
Vasodilation in the pulmonary arteries is induced by the excess production of Nitrous oxide (NO) (Zhang, 2012). The molecular pathway is depicted in figure 2 NO production is achieved via ET-1/ETalpha receptor-driven eNOS stimulation and iNOS in intravascular monocytes and CO production (increased levels of HMOX1) in monocytes (Zhang, 2012). Monocytes attach to the pulmonary vasculare and produce…