Question

Why do patients with severe ascites manifest with hypoxemia (low SpO2) and dyspnea?

Answer 1

Ascites elevates the diaphragms and causes basilar atelectasis, which contributes to dyspnea and mild hypoxia. HPS is characterized by impaired oxygenation in the setting of chronic and acute liver disease. It is defined by the combination of liver disease, an increased alveolar-arterial gradient with impaired arterial oxygenation, and evidence of intrapulmonary vascular dilatations at the capillary and pre-capillary levels, as demonstrated by a positive echocardiogram. HPS occurs in liver disease referred for liver transplantation and occurs across the full range of etiologies of liver disease, regardless of the presence or absence of portal hypertension. The severity of underlying liver disease does not predict the presence of HPS or the degree of associated hypoxemia.

HPS :- Hepato pulmonary syndrome