Hypoxemia in patients with cirrhosis: relationship with liver failure and hemodynamic alterations.
OBJECTIVE
The relationship between hypoxemia, liver failure and the hemodynamic alterations in cirrhosis are unknown. This study examined the relationship between arterial hypoxemia, the severity of liver disease and hyperkinetic circulation in patients with cirrhosis.


METHODS
Arterial blood gases, the severity of cirrhosis (Child-Pugh score), and splanchnic and systemic hemodynamics were measured in 120 patients with cirrhosis and without cardiopulmonary disease. Hypoxemia was considered to be present when PaO2 was < or = 70 mmHg.


RESULTS
Seventeen patients had hypoxemia (14%). Hypoxemic patients had significantly lower pulmonary vascular resistance and a significantly higher alveolar-arterial oxygen gradient, Child-Pugh score and hepatic venous pressure gradient than non-hypoxemic patients. Cardiac index and right atrial and pulmonary pressures did not significantly differ between the two groups.


CONCLUSIONS
Hypoxemia occurs mainly in patients with severe liver disease and is associated with pulmonary vasodilation.
Vachiéry
F
F
Laboratoire d'Hémodynamique Splanchnique et de Biologie Vasculaire, Unité de Recherches de Physiopathologie Hépatique (INSERM U-24), Hôpital Beaujon, Clichy, France.
Moreau
R
R
Hadengue
A
A
Gadano
A
A
Soupison
T
T
Valla
D
D
Lebrec
D
D
D000328:Adult; D000368:Aged; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D017093:Liver Failure / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis