Therapeutic effects of diuretics and paracentesis on lung function in patients with non-alcoholic cirrhosis and tense ascites

Chang, Shi Chuan; Chang, Huei Ing; Chen, Funn Juh; Shiao, Guang-Ming; Wang, Sun Sang; Lee, Shou Dong

doi:10.1016/s0168-8278(97)80249-8

Cited by 16 publications

(15 citation statements)

References 31 publications

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“…Therefore, it is possible that we have underestimated the actual prevalence of COPD in our cohort. On the other hand, some studies have shown that diuresis or large‐volume paracentesis in patients with tense ascites increases FEV1 and FVC in parallel with an unchanged FEV1/FVC ratio 21, 22. Less than 50% of patients in our study had detectable ascites by physical examination, and this makes it less likely that this had a significant impact on our conclusions.…”

Section: Discussioncontrasting

confidence: 55%

Risk factors and impact of chronic obstructive pulmonary disease in candidates for liver transplantation

Rybak¹,

Fallon²,

Krowka³

et al. 2008

Liver Transpl

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Chronic obstructive pulmonary disease (COPD) may cause significant symptoms and have an impact on survival. Smoking is an important risk factor for COPD and is common in candidates for liver transplantation; however, the risk factors for and outcomes of COPD in this population are unknown. We performed a prospective cohort study of 373 patients being evaluated for liver transplantation at 7 academic centers in the United States. COPD was characterized by expiratory airflow obstruction and defined as follows: prebronchodilator forced expiratory volume in 1 second/forced vital capacity Ͻ 0.70. Patients completed the Liver Disease Quality of Life Questionnaire 1.0, which included the Short Form-36. The mean age of the study sample was 53 Ϯ 9 years, and 234 (63%) were male. Sixty-seven patients (18%, 95% confidence interval 14%-22%) had COPD, and 224 (60%) had a history of smoking. Eighty percent of patients with airflow obstruction did not previously carry a diagnosis of COPD, and 27% were still actively smoking. Older age and any smoking (odds ratio ϭ 3.74, 95% confidence interval 1.94-7.23, P Ͻ 0.001) were independent risk factors for COPD. Patients with COPD had worse New York Heart Association functional class and lower physical component summary scores on the 36-Item Short Form but had short-term survival similar to that of patients without COPD. In conclusion, COPD is common and often undiagnosed in candidates for liver transplantation. Older age and smoking are significant risk factors of COPD, which has adverse consequences on functional status and quality of life in these patients.

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Section: Discussioncontrasting

confidence: 55%

Risk factors and impact of chronic obstructive pulmonary disease in candidates for liver transplantation

Rybak¹,

Fallon²,

Krowka³

et al. 2008

Liver Transpl

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“…In patients with ascites, large ascites restrict full inflation of the respiratory system and decrease ventilation to the basal lung zones. All these effects may lower the ventilation-perfusion ratio and worsen gas exchange (25).…”

Section: Discussionmentioning

confidence: 99%

“…In the long term, TIPS may improve the respiratory alkalosis observed in cirrhosis, reflecting a better correlation between tissue O2 demand and O2 transport. crease in O2 tension in the paracentesis group could result from a difference in the conditions at inclusion and 4 months later, since paracentesis could increase vascular vasodilatation (30) and worsen gas exchange (25). In fact, studies were performed under the same conditions: 24 h after total paracentesis and without diuretic or vasoactive treatment.…”

Section: Discussionmentioning

confidence: 99%

Influence of transjugular intrahepatic portosystemic shunts (TIPS) on tissue oxygenation in patients with cirrhosis

Denié

Vachiéry

Gadano

et al. 1998

Liver

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“…1). Before the establishment of their diagnosis, exclusion of other etiologies of lung disease, as well as the presence and impact of other manifestations of advanced liver disease, such as hepatic hydrothorax (HH), ascites and muscle wasting, on pulmonary function must be evaluated [4]. More particularly, the development of pleural effusions in the context of decompensated cirrhosis, known as HH, may cause severe respiratory dysfunction resistant to treatment.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary manifestations of chronic liver disease: a comprehensive review

Σουλαϊδόπουλος

Goulis

2020

aog

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Hepatopulmonary syndrome (HPS) and porto-pulmonary hypertension (PoPH) represent relatively common pulmonary vascular complications of advanced liver disease. Despite distinct differences in their pathogenetic background, both clinical states are characterized by impaired arterial oxygenation and limited functional status, and are associated with increased pretransplantation mortality. Accumulation of ascitic fluid in the pleural cavity, known as hepatic hydrothorax (HH), is another frequent manifestation of decompensated cirrhosis, which may cause severe respiratory dysfunction, depending on the volume of the effusion, the rapidity of its development and its resistance to therapeutic measures. Orthotopic liver transplantation constitutes the only effective treatment able to resolve the pulmonary complications of liver disease. A prioritization policy for liver transplantation has evolved over the past years regarding advanced stages of HPS, yielding favorable outcomes regarding post-transplantation survival and HPS resolution. In contrast, severe PoPH is associated with poor post-transplantation survival. Hence, liver transplantation is recommended only for patients with PoPH and an acceptable reduction in pulmonary pressure values, after receiving PoPH-targeted vasodilating therapy. This review focuses on basic pathogenetic and diagnostic principles and discusses the current therapeutic approaches regarding HPS, PoPH, and HH.

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Therapeutic effects of diuretics and paracentesis on lung function in patients with non-alcoholic cirrhosis and tense ascites

Cited by 16 publications

References 31 publications

Risk factors and impact of chronic obstructive pulmonary disease in candidates for liver transplantation

Risk factors and impact of chronic obstructive pulmonary disease in candidates for liver transplantation

Influence of transjugular intrahepatic portosystemic shunts (TIPS) on tissue oxygenation in patients with cirrhosis

Pulmonary manifestations of chronic liver disease: a comprehensive review

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