A Study of Arterial Blood Gas (ABG) Values in Liver Cirrhosis and Ascites

Abstract

Background:In cirrhotic patients, in addition to hepatocyte and Kuppfer cells dysfunction, portopulmonary shunt, intrapulmonary arteriovenous shunt and VA/Q inequality can induce a decrease in PaO2 and SaO2 as well as acid base disturbances. The present study was done to analyse arterial blood gas changes, prevalence of hypoxemia and acid base disturbances as well as to correlate grading of hypoxemia with different aetiologies and Child-Pugh score in patients with liver cirrhosis and ascites. Methods: The present correlative cross sectional study was conducted on 100 patients with cirrhosis and ascites for a period of 24 months. Arterial blood gas samples obtained by percutaneous radial puncture were analysed for various acid base abnormalities and arterial blood gas oxygenation. Results: Acid base disturbances observed were: respiratory alkalosis in 39 cases (39%), metabolic alkalosis in 20 cases (20%), metabolic acidosis in 11 cases (11%), metabolic acidosis with respiratory alkalosis in 10 cases (10%) and no acid base disturbance in 20 cases (20%). Mean values of PaO2 was 75.85±7.8 mmHg, PaCO2 was 35.27±5.13 mmHg, pH was 7.44±.115 and HCO 3was 23.65±3.85 mmol/l. Alcoholic cirrhotics had hypoxemia in 42% cases in contrast to hypoxemia in other aetiologies ( Hepatitis C 18%, Hepatitis B 5%).Conclusion: Metabolic abnormalities, hypoxemia and hypocapnia are commonly found in cirrhotics. Hypoxemia is more common in alcoholic cirrhotics but has no correlation with Child-Pugh score.