Respiratory problems associated with liver disease in children.

IF 2.3 Q2 RESPIRATORY SYSTEM
Breathe Pub Date : 2024-03-01 Epub Date: 2024-04-09 DOI:10.1183/20734735.0150-2023
Jordache Ellis, Tassos Grammatikopoulos, James Cook, Akash Deep
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Abstract

Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory manifestations can result in complex challenges when managing patients and requires clinicians to be able to recognise when referral to specialists is required. While liver transplantation is at the centre of treatment, it opens up further potential for respiratory complications. It is established that these complications place patients at risk of longer stays in hospital and reduced survival. Additionally, late post-transplant complications can occur, including post-transplant lymphoproliferative disease and immunosuppression-induced interstitial lung disease. Although rare, it is important for clinicians to recognise these conditions to allow for prompt management. Finally, as liver disease progresses in children, respiratory complications can occur. Hepatopulmonary syndrome can occur in the context of portal hypertension, resulting in increased mortality and poorer quality of life for patients. Another consequence is portopulmonary hypertension, which can be associated with poor survival. Failure to recognise these complications in children may result in poorer outcomes and therefore it is vital that clinicians can establish when referral to a paediatric respiratory medicine specialist is required.

与儿童肝病相关的呼吸系统问题。
慢性肝病的呼吸系统表现对患者的临床疗效影响深远。儿科肝病的某些病症与呼吸系统病理有关。肝脏和呼吸系统表现之间的这种重叠可能会给患者的管理带来复杂的挑战,并要求临床医生能够识别何时需要转诊给专科医生。虽然肝移植是治疗的核心,但它为呼吸系统并发症的发生提供了更多可能。已经证实,这些并发症会使患者面临住院时间延长和存活率降低的风险。此外,还可能出现移植后晚期并发症,包括移植后淋巴增生性疾病和免疫抑制引起的间质性肺病。虽然这种情况很少见,但临床医生必须认识到这些情况,以便及时处理。最后,随着儿童肝病的进展,可能会出现呼吸系统并发症。肝肺综合征可在门静脉高压的情况下发生,导致患者死亡率增加,生活质量下降。另一个后果是门静脉高压症,这可能与存活率低有关。如果不能识别儿童的这些并发症,可能会导致较差的预后,因此临床医生必须确定何时需要转诊至儿科呼吸内科专科医生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Breathe
Breathe RESPIRATORY SYSTEM-
CiteScore
2.90
自引率
5.00%
发文量
51
审稿时长
12 weeks
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