| Summary: | <p>Abstract</p> <p>Background</p> <p>Hepatopulmonary syndrome (HPS) is a rare complication of liver diseases of different etiologies and may indicate a poor prognosis. Therefore, a simple non-invasive screening method to detect HPS would be highly desirable. In this study pulse oximetry was evaluated to identify patients with HPS.</p> <p>Methods</p> <p>In 316 consecutive patients with liver cirrhosis (n = 245), chronic hepatitis (n = 69) or non-cirrhotic portal hypertension (n = 2) arterial oxygen saturation (SaO<sub>2</sub>) was determined using a pulse oximeter. In patients with SaO<sub>2 </sub>≤92% in supine position and/or a decrease of ≥4% after change from supine to upright position further diagnostic procedures were performed, including contrast-enhanced echocardiography and perfusion lung scan.</p> <p>Results</p> <p>Seventeen patients (5.4%) had a pathological SaO<sub>2</sub>. Four patients (1.3%) had HPS. HPS patients had a significant lower mean SaO<sub>2 </sub>in supine (89.7%, SD 5.4 <it>vs</it>. 96.0%, SD 2.3; p = 0.003) and upright position (84.3%, SD 5.0 <it>vs</it>. 96.0%, SD 2.4; p = 0.001) and had a lower mean PaO<sub>2 </sub>(56.2 mm Hg, SD 15.2 <it>vs</it>. 71.2 mm Hg, SD 20.2; p = 0.02) as compared to patients without HPS. The mean ΔSaO<sub>2 </sub>(difference between supine and upright position) was 5.50 (SD 7) in HPS patients compared to non-HPS patients who showed no change (p = 0.001). There was a strong correlation between shunt volume and the SaO<sub>2 </sub>values (R = -0.94).</p> <p>Conclusion</p> <p>Arterial SaO<sub>2 </sub>determination in supine and upright position is a useful non-invasive screening test for HPS and correlates well with the intrapulmonary shunt volume.</p>
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