Pulmonary blood volume and transit time in cirrhosis: relation to lung function.
OBJECTIVE
In cirrhosis a systemic vasodilatation leads to an abnormal distribution of the blood volume with a contracted central blood volume. In addition, the patients have a ventilation/perfusion imbalance with a low diffusing capacity. As the size of the pulmonary blood volume (PBV) has not been determined separately we assessed PBV and pulmonary transit time (PTT) in relation to lung function in patients with cirrhosis and in controls.


METHODS
Pulmonary and cardiac haemodynamics and transit times were determined by radionuclide techniques in 22 patients with alcoholic cirrhosis and in 12 controls. The lung function including diffusing capacity for carbon monoxide (DL, CO) was determined by conventional single breath technique.


RESULTS
In the patients, PTT was shorter, 3.9+/-1.2 vs 5.7+/-1.0 s in the controls, P<0.001, and the PBV was lower, 362+/-151 vs 587+/-263 ml, in the controls, P<0.005. Both PTT and PBV were lowest in patients with advanced disease. DL, CO was reduced in the patients and correlated significantly with PTT (r=0.58, P=0.007) and PBV (r=0.49, P<0.03).


CONCLUSIONS
The results suggest that the reduced PBV contributes to the reduced effective blood volume in cirrhosis. The relation between PBV and PTT and the low diffusing capacity suggests the pulmonary vascular compartment as an important element in the pathophysiology of the lung dysfunction in cirrhosis.
Møller
Søren
S
Department of Clinical Physiology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark. soeren.moeller@hh.hosp.dk
Burchardt
Hans
H
Øgard
Christina G
CG
Schiødt
Frank V
FV
Lund
Jens O
JO
D000368:Aged; D001776:Blood Circulation Time; D001810:Blood Volume; D002248:Carbon Monoxide; D018450:Disease Progression; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation; D011653:Pulmonary Diffusing Capacity; D012129:Respiratory Function Tests
D002248:Carbon Monoxide