Abstract
Purpose Acid-base disturbances were investigated in patients with cirrhosis in relation to hemodynamic derangement to analyze the hyperventilatory effects and the metabolic compensation. Methods A total of 66 patients with cirrhosis and 44 controls were investigated during a hemodynamic study. Results Hyperventilatory hypocapnia was present in all patients with cirrhosis and progressed from Child class A to C (P<0.01). Arterial pH increased significantly from class A to C (P<0.001) and was correlated inversely to the mean arterial blood pressure (r=-0.30, P<0.02), systemic vascular resistance (r=-0.25, P<0.05), indocyanine green clearance (r=-0.37, P<0.005), and serum sodium (r=-0.38, P<0.002). Metabolic compensation was shown by a reduced standard base excess in all patients (P<0.001). Standard base excess contained elements related to changes in serum albumin, water dilution, and effects of unidentified ions (all P<0.001). A significant hepatic component in the acid-base disturbances could not be identified. Conclusion Hypocapnic alkalosis is related to disease severity and hyperdynamic systemic circulation in patients with cirrhosis. The metabolic compensation includes alterations in serum albumin and water retention that may result in a delicate acid-base balance in these patients.
| Original language | English |
|---|---|
| Journal | European journal of gastroenterology & hepatology |
| Volume | 27 |
| Issue number | 8 |
| Pages (from-to) | 920-7 |
| Number of pages | 8 |
| ISSN | 0954-691X |
| DOIs | |
| Publication status | Published - 11 Jul 2015 |
Keywords
- Acid-Base Equilibrium
- Adult
- Aged
- Alkalosis, Respiratory
- Biomarkers
- Case-Control Studies
- Female
- Hemodynamics
- Humans
- Hydrogen-Ion Concentration
- Hyperventilation
- Hypocapnia
- Kaplan-Meier Estimate
- Liver Circulation
- Liver Cirrhosis
- Male
- Middle Aged
- Models, Biological
- Prognosis
- Risk Factors
- Serum Albumin
- Severity of Illness Index
- Sodium
- Time Factors