Abstract and Introduction
Acute respiratory failure has a high mortality in patients with end-stage liver disease (ESLD). These patients may develop acute respiratory failure for reasons specific to advanced liver disease, including hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. They may also develop respiratory complications due to conditions seen in the general intensive care unit population to which ESLD patients are at higher risk, including infection, volume overload, and the acute respiratory distress syndrome. Management of these patients is complicated and multifaceted, and a comprehensive understanding of the etiologies and treatment of acute respiratory failure is critical in this high-risk patient population. This article reviews current evidence surrounding the prevalence, management, and complications of the various etiologies of acute respiratory failure in ESLD patients.
Patients with end-stage liver disease (ESLD) may develop acute respiratory failure for a variety of reasons. Certain etiologies of respiratory failure are specific to ESLD, while others are seen in the general intensive care unit (ICU) population to which ESLD patients are more susceptible, including infection, volume overload, and the acute respiratory distress syndrome (ARDS). As acute respiratory failure has a higher mortality in ESLD patients compared with the general ICU population, an understanding of appropriate management, while challenging and complex, is particularly crucial in this vulnerable patient population. This article reviews the etiology and management of respiratory failure in advanced liver disease.
Semin Respir Crit Care Med. 2018;39(5):546-555. © 2018 Thieme Medical Publishers