ABSTRACT
Hepatopulmonary syndrome [HPS] refers to arterial hypoxemia caused by pulmonary vasodilation, which is a consequence of portal hypertension. HPS is associated with increased morbidity and mortality; thus, it is important to diagnose this entity as soon as possible for treatment to be administered. In a cross-sectional study, 40 children [6 months to 14 years old] with chronic liver disease were enrolled. In all patients, measurements of Oxygen saturation [SaO[2]] were performed with a pulse oximeter in the supine position [SPO[2]] and then in the upright position [delta SPO[2]]. Children were divided into three groups: i] those with both SPO[2]>96% and deltaSPO[2]>4%; ii] children with either SPO[2]>96% or delta SPO[2] > 4%; and iii] those with neither of these signs. Then, contrast-enhanced echocardiography [CEE] and arterial blood gas [ABG] were performed. Finally, the prevalence of mild to moderate HPS was calculated in the three groups. There were 30 patients who had neither of the two signs, of which 9 had HPS. Ten patients had one of the two signs, in whom 4 had HPS. None of the patients had both signs. The sensitivity of the pulse oximetry was 30%, specificity was 77%, positive predictive value was 38% and negative predictive value was 70%.There is a significant prevalence of HPS in cirrhotic patients which effects prognosis. Based on our study results, we have determined that pulse oximetry could not be a reliable screening procedure in mild to moderate HPS. It is recommended to use gold standard tests [echocardiography and arterial blood gasometry] for the screening and diagnosis of HPS in children.