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Previous Volume 331:1098 October 20, 1994 Number 16 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: The hepatopulmonary syndrome, which is characterized by hypoxemia due to intrapulmonary shunting or a ventilation-perfusion mismatch (or both), develops in some patients with liver cirrhosis. Patients with this syndrome have no apparent parenchymal lung disease but may have orthodeoxia, the unusual finding of increased hypoxemia with the change from a supine to a standing position.¹

Increased endogenous production of nitric oxide may play a part in the hyperdynamic circulation that is typical of patients with the hepatopulmonary syndrome. An increased concentration of exhaled nitric oxide has recently been reported in one such patient; hypoxemia resolved and the . . . [Full Text of this Article]

References

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• Luo, B., Liu, L., Tang, L., Zhang, J., Ling, Y., Fallon, M. B. (2004). ET-1 and TNF-{alpha} in HPS: analysis in prehepatic portal hypertension and biliary and nonbiliary cirrhosis in rats. Am. J. Physiol. Gastrointest. Liver Physiol. 286: G294-G303 [Abstract] [Full Text]  
• Leff, B., Burton, J. R. (2001). The Future History of Home Care and Physician House Calls in the United States. J. Gerontol. A Biol. Sci. Med. Sci. 56: M603-608 [Abstract] [Full Text]  
• Groneberg, D. A., Fischer, A. (2001). Methylene Blue Improves the Hepatopulmonary Syndrome. ANN INTERN MED 135: 380-380 [Full Text]  
• Boling, P. A., Rowe, J. S., Hammerman-Rozenberg, R., Cohen, A., Stessman, J., Leff, B., Burton, J. R., Steel, R. K., Lechich, A. J., Meyer, G. S., Gibbons, R. V., Campion, E. W. (1998). House Calls. NEJM 338: 1466-1468 [Full Text]