Frequency of Pulmonary Arterial Hypertension among patients of liver cirrhosis presenting with Acute Respiratory Failure

Background: liver cirrhosis with respiratory failure is frequent cause of admission in critical care unit. Sometime no etiological factor other than hepatopulmonary syndrome is labelled. Does pulmonary arterial hypertension matters in hepatopulmonary syndrome? Aim: To assess the frequency of pulmonary hypertension among liver cirrhosis patients presenting with respiratory failure at Critical care unit Ittefaq Hospital Model Town Lahore Pakistan. Methods: Doppler echocardiography was performed for assessments of pulmonaryarterial systolic pressure (PASP) on 80 consecutive patients who were known case of liver cirrhosis (48) men and 32 women) aged > 20 years, admitted to critical care unit at Ittefaq Hospital Model Town Lahore with respiratory failure. Pulmonary hypertension was prospectively defined as a tricuspid regurgitant jet velocity (TRJV) of at least 2.5 m per second which can be estimate pulmonary artery systolic pressure (PASP) equal or more than 25mmHg on transthoracic echocardiograpgy Results: Doppler-defined pulmonary arterial hypertension was diagnosed in 8.75% among 80 patients included in study using a cutoff of PASP ≥25 mmHg. Conclusion: The prevalence of PAH among adults liver cirrhotic patient is higher than that reported from the developed countries. Further assessment using invasive techniques is required coupled with analytical study design to predict the factors that favor the development of PAH among liver cirrhotic patients is required. Early detection of hepatopulmonary HPT may help in management plan in the form of liver transplant.