{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:03:13Z","timestamp":1740164593580,"version":"3.37.3"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2018,1,1]],"date-time":"2018-01-01T00:00:00Z","timestamp":1514764800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p>We present the case of a 68-year-old gentleman who presented with breathlessness and was found to have NSTEMI, pulmonary oedema, and hypoxia. He remained hypoxic despite appropriate treatment and was found to have preserved LV function and raised cardiac output. CT pulmonary angiogram was negative but a cirrhotic liver was incidentally noted and later confirmed via ultrasound. Bedside examination was positive for orthodeoxia, suggesting a diagnosis of hepatopulmonary syndrome (HPS). The finding of significant intrapulmonary shunting on \u201cbubble\u201d echocardiography confirmed the diagnosis. This patient did not have previously diagnosed liver disease and had largely normal LFTs when the diagnosis was first suspected. We discuss HPS in the context of ICU and suggest how it may be screened for using simple tests. There is no correlation between the presence of HPS and severity of liver disease, yet we believe this is the first reported adult case of HPS on the ICU without previously diagnosed cirrhosis.<\/jats:p>","DOI":"10.1155\/2018\/3417259","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T19:31:12Z","timestamp":1523993472000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["An Unusual Case of Refractory Hypoxia on the ICU"],"prefix":"10.1155","volume":"2018","author":[{"given":"Caroline","family":"Phillips","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0759-1371","authenticated-orcid":true,"given":"Nathaniel","family":"Broughton","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Pulimood","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam","family":"Ring","sequence":"additional","affiliation":[{"name":"Department of Cardiology, West Suffolk NHS Foundation Trust, Bury St Edmunds, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"issue":"1","key":"1","first-page":"31","volume":"28","year":"2015","journal-title":"Annals of Gastroenterology"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.79.927.18"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1136\/gut.46.1.1"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S3608"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.34.4.447"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200201-027OC"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-133-9-200011070-00012"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01048.2006"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21141"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90589-8"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.3.615"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.900530"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcpc049023"},{"issue":"10","key":"14","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s13312-014-0510-0","volume":"51","year":"2014","journal-title":"Indian Pediatrics"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.149526"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-8-418"},{"issue":"4","key":"17","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0025-6196(12)61253-1","volume":"59","year":"1984","journal-title":"Mayo Clinic Proceedings"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.1997.v26.pm0009328302"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197604222941711"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.5.1165"},{"key":"21","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1183\/09031936.04.00010904","volume":"24","year":"2004","journal-title":"European Respiratory Journal"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2018\/3417259.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2018\/3417259.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2018\/3417259.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T19:31:14Z","timestamp":1523993474000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/cricc\/2018\/3417259\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":21,"alternative-id":["3417259","3417259"],"URL":"https:\/\/doi.org\/10.1155\/2018\/3417259","relation":{},"ISSN":["2090-6420","2090-6439"],"issn-type":[{"type":"print","value":"2090-6420"},{"type":"electronic","value":"2090-6439"}],"subject":[],"published":{"date-parts":[[2018]]}}}