Criteria for Hepatopulmonary Syndrome & Grading Severity

 

Criteria for the hepatopulmonary syndrome:

(1) severe liver disease

(2) pulmonary vascular defect by contrast-enhanced echocardiography and/or radioactive lung-perfusion scanning

(3) oxygenation defect with the alveolar-arterial oxygen gradient (PAO2 - PaO2) >= 15 mm Hg while breathing ambient air

 

where:

• Breathing ambient air is based on being at or near sea level.

• Most patients with hepatopulmonary syndrome have cirrhosis with portal hypertension. However, it can also occur with portal hypertension without cirrhosis, hepatitis and acute hepatic failure.

PaO2 on ambient air	Grade
>= 80 mm Hg	mild
60 to 79.9 mm Hg	moderate
50 to 59.9 mm Hg	severe
< 50 mm Hg	very severe

 

With very severe disease, PaO2 is < 300 mm Hg when breathing 100% oxygen.