Oxygenation improvement with almitrine bismesylate in the hepatopulmonary syndrome

SummaryA 51 years old male patient was referred for dyspnoea on minimal exertion associated with a severe hypoxemia (PaO2=66 mmHg) and respiratory alkalosis. Investigations led to the diagnosis of hepatopulmonary syndrome. PaO2 increased from 60 to 75 mmHg after one hour of i.v. almitrine bismesylate infusion, and it remained at 85 mmHg after 3 months of further per os treatment. This case of hepatopulmonary syndrome is the first to be persistently improved by almitrine bismesylate. Increase of PaO2 would at least delay the hepatic transplantation.