Study of arterial blood gases in different stages of chronic liver diseases

Abstract

BackgroundEarly detection of arterial gas abnormalities and acid–base disturbances in patients with chronic liver disease is essential to improve prognosis on the basis of pulmonary and liver diseases. The aim of the current study was to detect arterial blood gas changes, acid–base disturbances, and prevalence of hepatopulmonary syndrome (HPS) in different classes of severity of chronic hepatic disease for achieving a higher survival rate.ResultsPatients with hypoxemia represented 38 (33.6%) cases: three (15.7%) of 19 patients in group A, 16 (33.3%) of 48 patients in group B, 12 (34.2%) of 35 patients in group C, and seven (63.6%) of 11 patients with encephalopathy. Highly statistically significant decreases in arterial blood partial pressure of O2 and oxygen saturation were found with the increase in the severity of the hepatic disease and cirrhosis as assessed using the Child–Pugh score. Moreover, partial pressure of O2 was lowest in patients with encephalopathy. HPS was present in 22 (19.4%) patients with hypoxemia. A total of 12 patients were Child class C, eight patients were Child class B, and two patients were Child class A. Acid–base disturbances were observed in 82 (72.6%) patients, respiratory alkalosis in 49 (43.4%) patients, metabolic alkalosis in 10 (8.8%) patients, metabolic acidosis in seven (6.2%) patients, respiratory acidosis in eight (7.1%) patients, and mixed disturbances in eight (7.1%) patients.ConclusionsPatients with hypoxemia were found to have a higher score of Child–Pugh than patients not having hypoxemia. HPS was found in all three Child–Pugh classes but mostly in Class C, so it is recommended that every patient with chronic liver disease should be evaluated and assessed for therapeutic decision, control of symptoms, improving survival, and quality of life.