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 |
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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 - Aug 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