Treatment of Liver Cirrhosis in Hepatopulmonary Syndrome with PaO₂ Below 60 mmHg

This protocol addresses a specific and severe complication in patients with liver cirrhosis: the development of hepatopulmonary syndrome (HPS) accompanied by a partial pressure of arterial oxygen (PaO₂) falling below 60 mmHg, indicating severe hypoxaemia.

Clinical scenario

Patient with liver cirrhosis diagnosed with hepatopulmonary syndrome, presenting with partial pressure of arterial oxygen below 60 mmHg (severe hypoxaemia).

Treatment approach

Management in this setting involves a long-term respiratory support strategy targeting the severe hypoxaemia associated with HPS. This approach is considered alongside evaluation for the definitive intervention shown to reverse HPS.

The complete regimen — including full criteria, sequencing, and evidence grading — is available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

Patients with HPS and PaO2 <60 mmHg should be evaluated for LT since it is the only treatment for HPS that has been proven to be effective to date (II-2;1).

Long-term oxygen therapy is recommended in patients with HPS and severe hypoxaemia. Nevertheless, there is no available data concerning effectiveness, tolerance, cost-effectiveness, compliance and effects on survival rates of this therapy (II-2;1).

DOI: 10.1016/j.jhep.2018.03.024

View source ↗