The recent article “Intrapulmonary Shunt Is a Potentially Unrecognized Cause of Ischemic Stroke and Transient Ischemic Attack” (TIA) by Abushora et al. raises several questions in our daily clinical evaluation of patients with stroke, and also divers with unexplained Type II decompression sickness (DCS). A cohort of patients (stroke group) with either nonhemorrhagic stroke (CVA) or TIA (n = 321...

We report a 70-year-old man with hepatopulmonary syndrome (HPS) in C liver cirrhosis. Hypoxemia worsened markedly, especially on exertion, while the hepatic function was clinically stable. Contrast echocardiography, 99mTc macroaggregated albumin (99mTcMAA) lung scan, and pulmonary angiography were performed. The findings suggested the presence of both intrapulmonary vascular dilatation and subs...

OBJECTIVE To determine the frequency of hepatopulmonary syndrome in children with chronic liver disease, and its clinical and biochemical associations. METHOD This study included 53 children with chronic liver disease, who underwent contrast echocardiography with agitated saline and measurement of arterial blood gases. RESULTS Of the 53 patients studied, 18 had intrapulmonary shunting of bl...

OBJECTIVE To investigate the effects of stellate ganglion block (SGB) on the peri-operative vasomotor cytokine content and intrapulmonary shunt in patients with esophagus cancer who underwent thoracotomy. MATERIALS AND METHODS Forty patients undergoing elective resection of esophageal cancer patients who had I~II American Society of Anesthesiologist (ASA) were randomly divided into total intr...

A 51-year-old highly fit man presented for dyspnea with strenuous aerobic exercise. The patient was asymptomatic and all tests were normal at rest. With increasing exercise intensity, he suddenly complained of dyspnea and showed a severe exercise-induced hypoxemia with an excessive alveolar-arterial oxygen tension difference. In agitated saline contrast echocardiography at peak exercise, a larg...

BACKGROUND One-lung ventilation (OLV) is a common ventilation technology during thoracic surgery that can cause serious clinical problems. We aimed to conduct a meta-analysis to compare oxygenation and intrapulmonary shunt during OLV in adults undergoing thoracic surgery with dexmedetomidine (Dex) versus placebo to assess the influence and safety of using Dex. METHODS Randomized controlled tr...

Hepatopulmonary syndrome (HPS) is a serious complication of end-stage liver disease, which is characterized by hypoxia, intrapulmonary vascular dilatation, and liver cirrhosis. Liver transplantation (LT) is the only curative treatment modality for patients with HPS. However, morbidity and mortality after LT, especially in cases of severe HPS, remain high. This case report describes a patient wi...