Hepatopulmonary Syndrome (HPS): Diagnosis, Bubble Study & Management

Hepatopulmonary syndrome (HPS) explained for practising anaesthetists, intensivists and liver transplant teams. Learn the diagnostic triad, assess oxygenation, interpret agitated-saline contrast echocardiography, distinguish delayed intrapulmonary passage from early intracardiac shunting, and understand practical next steps. The bubble animation is illustrative, not a patient echocardiogram. Cycle timing is a clue, not a stand-alone diagnosis; interpret the route and study quality in clinical context. A positive contrast study alone does not establish HPS. Educational content for clinicians; not a substitute for patient-specific assessment or local protocols. References: Raevens S, Boret M, Fallon MB. Hepatopulmonary syndrome. JHEP Reports. 2022. https://pmc.ncbi.nlm.nih.gov/articles... Rana et al. British Society of Echocardiography guidance on agitated-saline contrast echocardiography. Echo Research and Practice. 2026. https://pmc.ncbi.nlm.nih.gov/articles... Bernard S, et al. Agitated Saline Contrast Echocardiography in the Identification of Intra- and Extracardiac Shunts. J Am Soc Echocardiogr. 2020. https://pubmed.ncbi.nlm.nih.gov/33153... Opening/transition music: “Gymnopédie No. 1” by Kevin MacLeod, licensed under Creative Commons Attribution 3.0 (CC BY 3.0). https://creativecommons.org/licenses/... Subscribe to LiverDoc for practical, evidence-based transplant anaesthesia teaching.