Search Results

BACKGROUND: It is well known that severe hypoxemia is often associated with liver cirrhosis without preexisting cardiac or pulmonary diseases. Pulmonary vascular impairments, more specifically, intrapulmonary shunting have been considered as a major mechanism. Intrapulmonary shunting arises from pulmonary vascular dilatation at the precapillary level or direct arteriovenous communication and has relationship with the characteristic skin findings of spider angioma. However, these results are mainly from Western countries where alcoholic and primary biliary cirrhosis are dominant causes of cirrhosis. It is uncertain that tie same is true in viral hepatitiss associated liver cirrhosis, which is dominant causes of liver cirrhosis in Korea. We investigated the incidences of hypoxemia and orthodeoxia in Korean cirrhotic patients dominantly composed of postnecrotic cirrhosis and the significance of intrapulmonary shunting as the suggested mechanism of hypoxemia. METHOD: We performed the arterial blood gas analysis separately both at the supine and errect position in 48 stable cirrhotic patients without the evidences of severe complications such as ascites, variceal bleeding, and hepatic coma. According to the results of arterial blood gas analysis, all patients were divided into hypoxemic and normoxemic group. In each group, pulmonary function test and Tc-99m-MAA whole body scan were performed. The shunting fraction was calculated based on the fact that the sum of cerebral and bilateral renal blood flow is 32% of the systemic blood flow. RESULTS: The hypoxemia of PaO2 less than 80 mmHg was observed in 9 patients(18.8%) and Orthodeoxia more than 10 mmHg was observed in 8 patients(16.7%). Hut there was no patient with significant hypoxemia of PaO2 less than 60 mmHg. PaO2 was significantly decreased in the patients with spider angioma than the patients without spider angioma and showed no correlation with the serologic type and severities of liver function test findings. Any parameters of pulmonary function test did not demonstrate the difference between normoxemic and hypoxemic group. But hypoxemic group showed significantly increased shunt fraction of 11.4+/-4.1% than normoxemic group of 4.1+/-2.0% (p<0.05). CONCLUSIONS: Hypoxemia is not infrequently observed complication in liver cirrhosis and intrapulmonary shunting is suggested to play a major role in the development of hypxemia. But there was no great likelihood of clinically significant hypoxemia in our domestic cirrhotic patients predominantly composed of postnecrotic type.
Alcoholics ; Anoxia* ; Ascites ; Blood Gas Analysis ; Dilatation ; Esophageal and Gastric Varices ; Fibrosis ; Hemangioma ; Hepatic Encephalopathy ; Humans ; Incidence ; Korea ; Liver Cirrhosis* ; Liver Cirrhosis, Biliary ; Liver Function Tests ; Liver* ; Lung Diseases ; Renal Circulation ; Respiratory Function Tests ; Skin ; Spiders ; Technetium Tc 99m Aggregated Albumin* ; Whole Body Imaging*

1.The Last Fifty Years of Western Medicine in Korea: Korean Academy of Tuberculosis and Respiratory Diseases.

2.Differences in thrombolytic effects in accordance with dosing- resimens of tissue- type plasminogen activator in experimental pulmonary embolism.

3.Clinical characteristics of diffuse panbronchiolitis.

4.Identification of mycobacterium tuberculosis in pleural effusion by polymerase chain reaction(PCR).

5.Diffuse reticular interstitial infiltrations accompanied by hyperinflation.

6.The effects of mycobacterium tuberculosis on alveolar macrophages.

7.Application of polymerase chain reaction(PCR) to the diagnosis of tuberculosis.

8.The role of hydroxyl radical in the pathogenetic mechanism of endotoxin-induced acute lung injury in rats.

9.Effect of ketanserin and positive end expiratory pressure ventilation on hemodynamics and gas exchange in experimental acute pulmonary embolism.

10.Hypoxemia In Liver Cirrhosis And Intrapulmonary Shunt Determination Using Tc-99m-MAA Whole Body Scan.

Display Mode

Output Records

File Type