Oxygenation improvement with almitrine bismesylate in the hepatopulmonary syndrome

Summary A 51 years old male patient was referred for dyspnoea on minimal exertion associated with a severe hypoxemia ( P aO 2 =66 mmHg) and respiratory alkalosis. Investigations led to the diagnosis of hepatopulmonary syndrome. P aO 2 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 P aO 2 would at least delay the hepatic transplantation.