To the Editor: The hepatopulmonary syndrome, which is characterizedby hypoxemia due to intrapulmonary shunting or a ventilation-perfusionmismatch (or both), develops in some patients with liver cirrhosis.Patients with this syndrome have no apparent parenchymal lungdisease but may have orthodeoxia, the unusual finding of increasedhypoxemia with the change from a supine to a standing position.1
Increased endogenous production of nitric oxide may play a partin the hyperdynamic circulation that is typical of patientswith the hepatopulmonary syndrome. An increased concentrationof exhaled nitric oxide has recently been reported in one suchpatient; hypoxemia resolved and the . . . [Full Text of this Article]
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