Pulmonary Dysfunction in Patients with Cirrhosis of the Liver: A Study of Pulmonary Function Tests and Arterial Blood Gases.

Pub Date : 2024-01-01 Epub Date: 2024-02-20 DOI:10.4103/ijabmr.ijabmr_367_23

Bhumika Vaishnav, Dasaradha Ramu Barla, Pailla Ruchitha, Aniruddh N Wadivkar, Tushar Tonde, Saish Mondkar

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Abstract

Background and aim: Respiratory complications in liver cirrhosis can occur due to various mechanisms, such as ascites causing restricted lung expansion and opening of intrapulmonary vascular shunts due to high portal pressures. We aimed to study the effects of the liver dysfunction on the lungs by evaluating arterial blood gas (ABG) and pulmonary function test (PFT) of all study subjects.

Subjects and methods: A cross-sectional study was done between August 2020 and September 2022. Diagnosed cases of the liver cirrhosis were enrolled in the study after informed consent and were subjected to the following investigations: chest X-ray, oximetry, spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), two-dimensional echocardiography, and ABG analysis (ABGA). The cases were divided into three groups based on their Child-Pugh staging, and statistical analysis was done on the collected data.

Results: A total of 64 (53 males and 11 females) patients with an average age of 49.82 ± 9.89 years were studied. Alcoholism was the most common cause of cirrhosis in males. Breathlessness (65.6%) and pleural effusion (26.6%) were the most common respiratory symptoms and signs, respectively. Seventeen patients had hepatic hydrothorax, eight patients had hepatopulmonary syndrome (HPS), and six patients had portopulmonary hypertension. Low pH (17.2%) and oxygen partial pressure (PaO₂) (20.3%) were the most common ABGA findings. The pH, PaO₂, forced expiratory volume in 1 s (FEV₁)/forced vital capacity (FVC), and DLCO were significantly low in Child Pugh Stage C (P < 0.05). The pH, pO₂, HCO₃, FEV₁, FVC, FEV₁/FVC, and DLCO were significantly lower in patients with HPS (P < 0.05).

Conclusion: Metabolic acidosis and low FEV₁/FVC and DLCO were the common findings in study subjects. Pulmonary dysfunction was common in advanced liver cirrhosis. Patients with HPS had worse ABG and PFT parameters than those without HPS.

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肝硬化患者的肺功能障碍：肺功能测试和动脉血气研究。

背景和目的：肝硬化患者的呼吸系统并发症可由多种机制引起，如腹水导致肺扩张受限和门静脉高压导致肺内血管分流开放。我们旨在通过评估所有研究对象的动脉血气（ABG）和肺功能测试（PFT），研究肝功能异常对肺部的影响：横断面研究在 2020 年 8 月至 2022 年 9 月期间进行。在获得知情同意后，确诊的肝硬化病例被纳入研究，并接受以下检查：胸部 X 光、血氧饱和度、肺活量、肺对一氧化碳的弥散能力（DLCO）、二维超声心动图和 ABG 分析（ABGA）。根据病例的 Child-Pugh 分期将其分为三组，并对收集的数据进行统计分析：研究共涉及 64 名患者（53 名男性和 11 名女性），平均年龄为 49.82 ± 9.89 岁。酗酒是男性肝硬化最常见的病因。呼吸困难（65.6%）和胸腔积液（26.6%）分别是最常见的呼吸系统症状和体征。17 名患者有肝性胸水，8 名患者有肝肺综合征（HPS），6 名患者有门静脉高压。低 pH 值（17.2%）和氧分压（PaO2）（20.3%）是最常见的 ABGA 检查结果。儿童普氏 C 期患者的 pH 值、PaO2 值、1 秒钟用力呼气容积（FEV1）/用力肺活量（FVC）和 DLCO 显著偏低（P < 0.05）。HPS患者的pH、pO2、HCO3、FEV1、FVC、FEV1/FVC和DLCO均明显偏低（P < 0.05）：结论：代谢性酸中毒、FEV1/FVC 和 DLCO 低是研究对象的共同发现。肺功能障碍在晚期肝硬化中很常见。与无 HPS 的患者相比，HPS 患者的 ABG 和 PFT 参数更差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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