[Tissue hypoxia and hepatocellular insufficiency in patients with cirrhosis].
To determine whether tissue hypoxia occurred in cirrhosis, oxygen contents, mixed venous and hepatic venous lactate concentrations as well as systemic hemodynamics were studied in 53 patients with cirrhosis. The influence of liver failure on tissue oxygenation was also studied. Cardiac index and mixed venous and hepatic venous lactate concentrations were significantly higher in patients with cirrhosis than in 20 control subjects. Oxygen consumption, oxygen extraction ratio and mixed venous and hepatic venous carbon dioxide tensions were significantly lower in the former than in the latter. Oxygen transport was not significantly different between the two groups. Cardiac index and oxygen transport were not significantly different between grade A (Pugh's classification) and grade C patients. Mixed venous as well as hepatic venous lactate concentrations were significantly higher while oxygen consumption, oxygen extraction ratio and carbon dioxide tensions were significantly lower in grade C than in grade A patients. We conclude that tissue hypoxia occurs in patients with cirrhosis and hepatic insufficiency. This tissue hypoxia might be due to arteriovenous shunting-related limitation of tissue oxygen extraction.
Moreau
R
R
Unité de Recherches de Physiopathologie Hépatique, INSERM U-24, Hôpital Beaujon, Clichy.
Braillon
A
A
Roulot
D
D
Hadengue
A
A
Gaudin
C
C
Cereda
J M
JM
Sicot
C
C
Lebrec
D
D
D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000032:analysis; D015687:Cell Hypoxia; D005260:Female; D006439:Hemodynamics; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010313:Partial Pressure
D002245:Carbon Dioxide
Hypoxie tissulaire et insuffisance hépatocellulaire chez les malades atteints de cirrhose.