Acid-base disturbance in patients with cirrhosis: relation to hemodynamic dysfunction

Jens H Henriksen, Flemming Bendtsen, Søren Møller

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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 languageEnglish
JournalEuropean journal of gastroenterology & hepatology
Volume27
Issue number8
Pages (from-to)920-7
Number of pages8
ISSN0954-691X
DOIs
Publication statusPublished - 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

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