Venegas-Sandoval JD, Altamirano GJT, Zapata IL, González AA, Rodríguez MA, Origel C

Language: Spanish
References: 15
Page: 121-125
PDF size: 48.54 Kb.

ABSTRACT

Background. The alterations of the gaseous exchange in the liver cirrhosis (LC) have related to advanced Child-Turcotte-Pugh (CTP). The most frequent alterations are hypoxemia, increase of the AaO2 and the hypocapnia. Objective. To describe the gas exchange alterations of patients with LC in Mexico City and the correlation of these with the functional CTP class. Material and methods. Clinical, prospective and descriptive trial. In-Patients with diagnosis of LC were included, all hospitalized in the Gastroenterology Department of the Hospital Juarez de Mexico from May to July of the 2007. Patients with cardio-pulmonary disease were excluded. Artery gasometric values was carried out and evaluated as normal with the validated parameters for Mexico City. The functional class of the LC was evaluated by means of the scale of CTP. We evaluated the clinical and biochemical variables. The not parametric variables were analyzed by means of χ² and the parametric ones by means of student test. Univariate Analysis was carried out with the adjusted gasometric parameters. Results. 62 patients complied inclusion criteria, 18 female and 44 male. The most frequent gas alterations were the increase of the AaO2, hypocapnia and hypoxemia. The PCO2 in CTP A (42.4 mm Hg ± 7.5); B (39.5 ± 7.9) and C (32.8 ± 9.1) with a p ‹ 0.0001. In univariate analysis, independent variables associated with hypocapnia were albumin ‹2.7 gr/dL (p = 0.04), INR › 1.7 (p = 0.001) and ascities (p = 0.003). Conclusions. The main gas alteration of cirrhotic in-patients in Mexico City was the increase of the AaO2, followed by hypocapnia. The only gasometric variable that impact in CTP was the hypocapnia. In relation to the presence of hypocapnia only the albumin, INR and moderate to severe ascities demonstrate association. Although physiopathology of hypocapnia, is not well understood, it can be a consequence of the activation of respiratory centers or well to constitute a compensatory mechanism to the hypoxemia and the restriction given by the ascities in this patients.

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