A 52-year-old man on ICU with chronic liver disease develops hepatopulmonary syndrome (HPS). His PaO2 is 6.5 kPa on room air. What pathophysiology underlies HPS? A Pulmonary fibrosis from liver disease B Intrapulmonary vascular dilatation (IPVD) - abnormal dilatation of pulmonary capillaries and precapillary arterioles, causing functional right-to-left shunting; blood passes through the dilated vessels too quickly for adequate gas exchange, and the dilated vessels shunt blood past ventilated alveoli C Hepatic hydrothorax D Portopulmonary hypertension E Ascites compressing the lungs
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