Archive for the ‘Hypoxemic Cirrhotic’ Category

Hemodynamic Disturbances and Va/Q Matching in Hypoxemic Cirrhotic Patients: ConclusionThese results are consistent with those of Daoud et al; however, two comments on Pv02, which was not measured in the previously cited study, should be made: (1) since a fall in Pv02 appears to contribute significantly to the HPV response magnitude, the hyperkinetic heart syndrome restoring normal Pv02 may have played a […]

Another possibility for the reduced Pa02 in cirrhotic patients with portal hypertension is the presence of anastomoses between the portal venous system and the low pressure pulmonary veins.- Unfortunately, this portopulmonary bypass could not be evaluated by the multiple inert gas method used in the present study. In addition, a significant difference between the measured Pa02 and the Pa02 predicted from the values of Va/Q distribution, Ve, and Q may […]

Hemodynamic Disturbances and Va/Q Matching in Hypoxemic Cirrhotic Patients: Pulmonary microcirculationOur results raised the problem of the mechanism of the impairment in gas exchange. Since the inert gas solution was always infused into a vein of the superior vena caval system, only intrathoracic shunt (iey an intracardiac or intrapulmonary shunt) could be evaluated. An extrathoracic origin of these Va/Q alterations could not be […]

A low Pa02 may result from an incomplete diffusion equilibrium, hypoventilation, or other alterations of Va/Q relationships, including intrapulmonary, extra-pulmonary, or postpulmonary shunt. The oxygen diffusion capacity has been found to be normal in patients with cirrhosis of the liver. Our patients also presented with hyperventilation leading to respiratory alkalosis, which is consistently observed in cirrhosis. The increased ventilation and the almost normal dead space effectively ruled out hypoventilation as […]

Hemodynamic Disturbances and Va/Q Matching in Hypoxemic Cirrhotic Patients: ResultsResults
Measured gas exchange and hemodynamic data are shown in Table 3. In these patients with severe hypoxemia, the Ve was increased, and Vo2 was raised, whereas the Pv02 was normal. Cardiac output and the Cl were extremely high, while the PVR and the SVR were extremely low. Finally, the P50 was increased […]

Preparation of Vtyients
Using a sterile introducer (Vygon Desilet No. 8), a No. 7F Swan-Canz catheter (Edwards Laboratories) was inserted percutaneously into a femoral vein and placed in the pulmonary artery under continuous electrocardiographic monitoring and fluoroscopic control. The tip of the catheter was positioned in the pulmonary artery to sample mixed-venous blood and to measure pulmonary capillary wedge and arterial pressure (Bentley-Trantec transducer model 800). A Seldicath catheter […]

Hemodynamic Disturbances and Va/Q Matching in Hypoxemic Cirrhotic PatientsArterial oxygen desaturation in patients with cirrho-L sis of the liver was first described by Snell in 1935; however, in spite of numerous studies, the mechanism of the alterations in gas exchange in these patients remains obscure. The diffusing capacity does not appear to be altered, and the shift to the right of the oxyhemoglobin […]

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