Indian Journal of Critical Care Case Report

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VOLUME 1 , ISSUE 2 ( September-October, 2022 ) > List of Articles


Refractory Hypoxemia with Hepatopulmonary Syndrome following Liver Transplant: Is there a Role of Trendelenburg Position? A Case Report

Kinjal K Purohit, Harda H Shah, Harsh J Panchal, Pranjal Modi, Bharat Tiwari

Keywords : Hepatopulmonary syndrome, Hypoxemia, Liver transplantation, Mechanical ventilation, Trendelenburg positioning, Ventilation perfusion mismatch

Citation Information : Purohit KK, Shah HH, Panchal HJ, Modi P, Tiwari B. Refractory Hypoxemia with Hepatopulmonary Syndrome following Liver Transplant: Is there a Role of Trendelenburg Position? A Case Report. 2022; 1 (2):42-45.

DOI: 10.5005/jp-journals-11006-0016

License: CC BY-NC 4.0

Published Online: 04-11-2022

Copyright Statement:  Copyright © 2022; The Author(s).


We report a case of a 50-year-old man who underwent liver transplantation for severe hepatopulmonary syndrome. Preoperatively, patient had orthodeoxia and platypnea leading to severe hypoxemia, requiring home oxygen therapy. Postoperatively, Trendelenburg position was given for the management of refractory hypoxemia. The outcome was measured by oxygen saturation using pulse oximetry and partial pressure of oxygen in ABGA. Post-transplant hypoxia for HPS can be managed in multiple ways but out of all of them, positioning is a simple maneuver without any severe complications that may correct the pathophysiologic abnormalities seen in HPS by gravitationally shifting blood away from the lung bases to improve oxygenation.

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