Introduction: Chronic liver disease with portal hypertension leads to many deleterious effects on multiple organ systems, including the pulmonary system. Portopulmonary hypertension and hepatopulmonary syndrome are the well recognised complications of chronic liver disease.

These pulmonary manifestations are in general less recognized by attending clinicians and are usually not given due importance in routine management of patients with chronic liver disease .

Objective : This study aimed to investigate the frequency of hypoxemia and impairment of pulmonary function tests in patients with chronic liver disease and to correlate  these impairments with the severity of liver cirrhosis as per child pugh score.

 Method: Fourty five patients with chronic liver disease without intrinsic cardiopulmonary disease were enrolled in this study. All the patients were subjected to complete clinical examination, Routine laboratory investigations, Pulse oximetry, Arterial blood gas analysis, Pulmonary function tests, Radiological investigations including abdominal ultrasound, chest x ray, Upper GI Endoscopy, ECG.  2D Echo was done in selected patients.

Results: Hypoxia was found in significant number of patients. Among the PFT parameters, FEV1 values were found to be lower in patients with severe liver disease. The presence of hypoxemia is increased in patients with advanced liver disease and its severity is positively correlated with the severity of liver disease. Clubbing, Orthodeoxia and Platypnea are important clinical indicators for hypoxia.

Conclusion: Chronic Liver disease is associated with distinctive pulmonary complications. Hypoxemia is a significant parameter found in considerable number of patients with chronic liver disease. Pulse oximetry is a easy, economical, and commonly available tool which reliably suggests the existence and severity of hypoxemia in patients with advanced liver disease. The timely detection of pulmonary dysfunctions in cirrhotic patients is decisive as it alters prognosis and helps in better management.