Hypoxia in Liver Cirrhosis (Liver Specific and Systemic Causes)

ABSTRACT

Background: During this covid pandemic hypoxia was one of the initial mode of screening diagnosis and follow-up. Hypoxia in liver cirrhosis patients is also not uncommon especially in late stages. Hypoxia can have varied causes either liver specific or systemic conditions. Aim: aim of our observational study was to find etiology, incidence, severity and hypoxia related mortality in patients with liver cirrhosis. Methods: we conducted an observational study over a period of two months a total of n=64 patients with liver cirrhosis with hypoxia were included in the study. Further follow up data was collected from their clinical work up. Mortality data was collected for their mean follow up periods from their inclusion in the study. Results: ACLF was found to be the most common cause of hypoxia in cirrhosis patients with n=24 (37.5%) with a mean spo2 of 86.4% Mortality in ACLF was 70.8%, second most common cause was covid pneumonitis n=17 (26.6%) with a mean spo2 of 82.6% and a mortality of 23.5%, Followed by sepsis n=10 (15.6%) with an average spo2 of 88% and mortality of 60%. Hepato-pulmonary syndrome was seen in n=8 (12.5%) average spo2 of 91% and mortality of 25% followed by hepatic and hydrothorax n=4 (6.25%) average spo2 of 92.5% with 25% mortality and one patient with porto- pulmonary syndrome with an spo2 of 93% no mortality. Conclusion: Novel corona virus induced hypoxia was second most common causes for hypoxia in the current pandemic era after ACLF. Though hypoxia in COVID pneumonitis was more severe than ACLF and sepsis but the mortality was higher in ACLF and sepsis subgroup. Prognosis and mortality in hypoxic cirrhosis depends on the etiology and does not directly corelate with the severity of spo2 directly.