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Region Hovedstaden - en del af Københavns Universitetshospital
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Acid-base disturbance in patients with cirrhosis: relation to hemodynamic dysfunction

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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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.
OriginalsprogEngelsk
TidsskriftEuropean journal of gastroenterology & hepatology
Sider (fra-til)871
Antal sider890
ISSN0954-691X
DOI
StatusUdgivet - aug. 2015

ID: 45379546