Definition Hepatopulmonary syndrome (HPS) is defined by an abnormally low arterial oxygen level associated with intrapulmonary vascular dilatations (IPVDs) in patients with liver disease. The presence of coexisting cardiopulmonary disease, which may contribute to impaired gas exchange, should be considered…
An association between advanced liver disease, ascites, and renal failure described in 1861 was named hepatorenal syndrome (HRS) by Helvig and Schutz in 1932. Until recently, HRS has been thought of as a purely functional form of renal failure without…
The change of a paradigm Portal hypertension is not the only driver of complications of cirrhosis Cirrhosis is typically classified as compensated or decompensated, based on the absence or presence (or previous history) of variceal bleeding, ascites, jaundice, or encephalopathy.…
Heart disease remains the leading cause of death in both men and women among African Americans, Hispanics, and Caucasians in the United States, accounting for nearly 650,000 deaths annually. Significant progress has been made over the past few decades in…
Rationale for using inotropic therapy in the critically ill Two different objectives for using inotropes in the critically ill have been considered: (1) the attempt to improve cardiac function in patients with low blood flow related to reduced myocardial contractility…
Introduction Shock can be defined as a state of circulatory failure to deliver sufficient oxygen to balance the demands of the tissues, which results in tissue hypoxia: a deficiency in the bioavailability of oxygen to the tissues of the body.…
Pathophysiology of shock Circulatory shock represents a final common pathway of cardiovascular failure. Septic shock is the most common cause of shock followed by cardiogenic and hypovolemic shock. Mortality remains high, particularly for patients with septic and cardiogenic shock, where…
Hypertension is a common problem, and population data suggest its incidence is increasing globally. One billion individuals worldwide now have hypertension. Nearly one in three US adults has hypertension. Compared with two-thirds in the past decade, currently half of these…
Pulmonary hypertension (PH) is defined by an elevated mean pulmonary artery pressure (mPAP) of >20 mm Hg and may be precapillary or postcapillary in etiology. Precapillary PH is further characterized by an elevated pulmonary vascular resistance (PVR) of ≥3 Wood…
Key concepts in the management of a critically ill patient with valvular heart disease are the use of echocardiography to provide an accurate diagnosis of disease severity and the appropriate use of invasive hemodynamic monitoring to optimize loading conditions. Physical…