Alterations in Arterial Blood Parameters in Patients with Liver Cirrhosis and Ascites [Abstract]

Alterations in Arterial Blood Parameters in Patients with Liver Cirrhosis and Ascites

Konstantinos Charalabopoulos^1,2, Dimitrios Peschos³, Leonidas Zoganas⁴, George Bablekos⁴, Christos Golias¹, Alexander Charalabopoulos¹, Dimitrios Stagikas¹, Angi Karakosta¹, Athanasios Papathanasopoulos⁵, George Karachalios², Anna Batistatou³

1. Department of Physiology, Clinical Unit, Medical Faculty, University of Ioannina, Ioannina, Greece.
2. Department of Medicine, Red Cross Hospital, Athens, Greece.
3. Department of Pathology, Medical Faculty, University of Ioannina, Ioannina, Greece.
4. Department of Thoracic Surgery, Red Cross Hospital, Athens, Greece.
5. Department of Medicine, Gastroenterology Unit, Medical Faculty, University of Ioannina, Ioannina, Greece.

In cirrhotic patients, in addition to hepatocytes and Kuppfer cells dysfunction circulatory anatomic shunt and ventilation/perfusion (V_A/ Q) ratio abnormalities can induce decrease in partial pressure of oxygen in arterial blood (PaO₂), in oxygen saturation of hemoglobin (SaO₂) as well as various acid-base disturbances. We studied 49 cases of liver cirrhosis (LC) with ascites compared to 50 normal controls. Causes were: posthepatic 37 (75.51%), alcoholic 7 (14.24%), cardiac 2 (4.08%), and cryptogenic 3 (6.12%). Complications were: upper gastrointestinal bleeding 24 (48.97), hepatic encephalopathy 20 (40.81%), gastritis 28 (57.14%), hepatoma 5 (10.2%), renal hepatic syndrome 2 (4.01%), HbsAg (+) 24 (48.97%), and hepatic pleural effusions 7 (14.28%). Average PaO₂ and SaO₂ were 75.2 mmHg and 94.5 mmHg, respectively, compared to 94.2 mmHg and 97.1 mmHg of the control group, respectively (p value in both PaO₂ and SaO₂was p<0.01). Respiratory alkalosis, metabolic alkalosis, metabolic acidosis, respiratory acidosis and metabolic acidosis with respiratory alkalosis were acid-base disturbances observed. In conclusion, portopulmonary shunt, intrapulmonary arteriovenous shunt and V_A/Q inequality can induce a decrease in PaO₂ and SaO₂ as well as various acid-base disturbances. As a result, pulmonary resistance is impaired and patients more likely succumb to infections and adult respiratory distress syndrome.

Keywords: liver cirrhosis, ascites, acid base disturbances, hepatopulmonary syndrome

How to cite this article:
Charalabopoulos K, Peschos D, Zoganas L, Bablekos G, Golias C, Charalabopoulos A, Stagikas D, Karakosta A, Papathanasopoulos A, Karachalios G, Batistatou A. Alterations in Arterial Blood Parameters in Patients with Liver Cirrhosis and Ascites. Int J Med Sci 2007; 4:94-97. Available from http://www.medsci.org/v04p0094.htm