Which pulmonary complication is associated with advanced hepatic disease and cirrhosis?

Increasing intrapulmonary shunting is a significant pulmonary complication associated with advanced hepatic disease and cirrhosis. In patients with liver cirrhosis, multiple factors contribute to this phenomenon, including the release of vasodilatory substances and the development of portopulmonary hypertension. These alterations can lead to impaired gas exchange in the lungs, where blood passes through areas that are not well ventilated, thereby reducing overall oxygenation in the bloodstream.

Intrapulmonary shunting occurs when blood moves from the right side of the heart to the left without undergoing adequate oxygenation in the lungs, which is common in patients with compromised liver function. This process results in hypoxemia and can be particularly pronounced in individuals whose liver disease has progressed significantly.

In contrast, conditions like restrictive or obstructive ventilatory defects, as well as increased functional residual capacity, do not directly correlate with the pulmonary changes observed in advanced hepatic disease. Those conditions typically relate to other underlying pulmonary issues rather than the specific pathophysiology seen in liver cirrhosis.