Decompensated cirrhosis is defined by the development of major complications of advanced liver disease and portal hypertension. In this episode, we review the core complications of decompensated cirrhosis, including esophageal variceal bleeding, spontaneous bacterial peritonitis, hepatorenal syndrome, and hepatic encephalopathy.

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Pulmonary physiology is essential for understanding hypoxemia, respiratory failure, oxygenation, V/Q mismatch, and shunt physiology. In this episode, we review ventilation-perfusion relationships, V/Q mismatch, pulmonary shunting, and the key differences between these mechanisms of impaired oxygenation.

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Hepatopulmonary syndrome and portopulmonary hypertension are two important pulmonary vascular complications of liver disease and portal hypertension. In this episode, we compare hepatopulmonary syndrome with portopulmonary hypertension, focusing on pathophysiology, clinical presentation, diagnostic evaluation, hemodynamics, treatment, and liver transplant considerations.

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Spontaneous bacterial peritonitis, or SBP, is a serious infection of ascitic fluid that occurs in patients with cirrhosis and portal hypertension. In this episode, we review the pathophysiology, clinical presentation, diagnostic evaluation, treatment, albumin use, and prophylaxis of spontaneous bacterial peritonitis.

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Hepatorenal syndrome is a serious kidney complication of advanced liver disease and portal hypertension. In this episode, we review the pathophysiology, diagnostic criteria, clinical evaluation, differential diagnosis, and treatment of hepatorenal syndrome.

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V/Q mismatch and pulmonary shunt are two major physiologic mechanisms of hypoxemia, but they affect oxygenation in different ways. In this episode, we compare ventilation-perfusion mismatch with pulmonary shunt physiology, focusing on how each develops, how they differ clinically, and why their response to supplemental oxygen is different.

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Pulmonary shunt is an important physiologic mechanism of hypoxemia and respiratory failure. In this episode, we review what a pulmonary shunt is, how shunt physiology affects oxygenation, how it differs from V/Q mismatch and dead space ventilation, and why shunt physiology often responds poorly to supplemental oxygen.

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Portopulmonary hypertension is an important pulmonary vascular complication of portal hypertension and advanced liver disease. In this episode, we review the pathophysiology, clinical presentation, diagnostic evaluation, hemodynamic criteria, and treatment of portopulmonary hypertension.

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Watch the full video on YouTube:https://www.youtube.com/watch?v=e02CbywSFQM

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Hemoptysis is an important clinical presentation that can range from minor blood-streaked sputum to life-threatening airway and respiratory failure. In this episode, we review the causes, initial evaluation, severity assessment, diagnostic approach, and management of hemoptysis.

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Watch the full video on YouTube:https://www.youtube.com/watch?v=aju1pgnTIXE

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V/Q mismatch is one of the most important physiologic mechanisms of hypoxemia and respiratory failure. In this episode, we review the physiology of ventilation-perfusion matching, high V/Q states, low V/Q states, shunt physiology, dead space ventilation, oxygen response, and the clinical relevance of V/Q mismatch.

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Watch the full video on YouTube: https://www.youtube.com/watch?v=lHEzgqx33HI

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