A Study for Hypoxemic Mechanisms in Liver Cirrhosis / 대한간학회지
The Korean Journal of Hepatology
;
: 197-204, 2000.
Article
in Korean
| WPRIM
| ID: wpr-101092
ABSTRACT
BACKGROUND/AIMS:
Hypoxemia is often associated with liver cirrhosis without cardiopulmonary diseases. Pulmonary vascular impairments including intrapulmonary shunt have been considered as a major mechanism of hypoxemia. The aim of this study was to determine the incidence and pathophysiologic basis of hypoxemia in cirrhotic patients without respiratory symptoms.METHODS:
In fourty three cirrhotic patients without heart and lung diseases, we performed the arterial blood gas analysis and calculated alveolar arterial oxygen gradient (A-aO2). According to the A-aO2, the patients were divided into hypoxemic and normoxemic groups. In each group, a Tc-99m-macroaggregated albumin (Tc-99m-MAA) scan, a contrast-enhanced echocardiography and a pulmonary function test were performed.RESULTS:
Twenty-eight of 43 patients (65%) showed hypoxemia. Hypoxemic patients showed significantly more increased shunt fraction of 3.1 1.4% than normoxemic one of 2.1 1.1% in the Tc-99m-MAA scan (p<0.05). However, only two of hypoxemic patients had shunt fraction above physiologic shunt range. By contrast-enhanced echocardiography, an intrapulmonary shunt was confirmed in one patient. There was no significant correlation between the shunt fraction and the hepatic reserve based on the Child-Pugh classification in hypoxemic patients. In the results of pulmonary function test, only DLco decreased more significantly in hypoxemic group than in normoxemic group (58.4 14.2 % vs 75.3 16.5% of predicted, p<0.05).CONCLUSIONS:
Hypoxemia is not infrequently observed in cirrhosis, but incidence of significant intrapulmonary shunt is low. Therefore, other mechanism such as diffusion defect may be suggested to play a role in the development of hypoxemia in cirrhotic patients without respiratory symptoms.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Oxygen
/
Respiratory Function Tests
/
Blood Gas Analysis
/
Fibrosis
/
Echocardiography
/
Technetium Tc 99m Aggregated Albumin
/
Incidence
/
Classification
/
Diffusion
/
Heart
Type of study:
Incidence study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
The Korean Journal of Hepatology
Year:
2000
Type:
Article
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