THERAPEUTIC EFFECTS OF DIURETICS AND PARACENTESIS ON LUNG-FUNCTION INPATIENTS WITH NONALCOHOLIC CIRRHOSIS AND TENSE ASCITES

Background/Aims: Ascites may cause or aggravate pulmonary dysfunction in patients with liver cirrhosis, Diuretics and paracentesis are the m ain therapies for ascites, The aim of the present study was to evaluat e and compare the therapeutic effects of diuretics and large-volume pa racentesis on lung function in 26 male patients with non-alcoholic cir rhosis and tense ascites, M Methods: The patients were divided into tw o groups, Group A was composed of 13 subjects who were treated,vith di uretics including spironolactone (100-400 mg/day) and furosemide (80-3 20 mg/day), In group B, 13 subjects received large-volume paracentesis plus intravenous albumin (6-8 g/l ascites removed), Pulmonary functio n tests including spirometry, plethysmography, single-breath carbon-mo noxide diffusing capacity (DLco) and arterial blood gases, were done 1 day before diuretic treatment and I day after termination of the stud y in group A patients, and I day before and after large-volume paracen tesis in group B subjects, Results: Before treatment, the clinical and laboratory data were comparable between the two groups, After treatme nt, ventilatory function as evidenced by forced expiratory volume in 1 s, forced vital capacity, total lung capacity, functional residual ca pacity and expiratory reserve volume, and DLco increased significantly in both groups, Arterial PO2 and PCO2 increased significantly and AaP O(2) (alveolar-arterial PO2 difference) decreased significantly in the subjects treated with diuretics, Nevertheless, paracentesis did not i mprove arterial blood gases, The changes in lung volumes, DLco and PaO 2 after treatment(the data after minus those before treatment) were co mparable, except that a significant decrease in AaPO(2) was observed i n the diuretic group, Conclusions: Both diuretic therapy and large-vol ume paracentesis significantly improved the ventilatory function in pa tients with tense cirrhotic ascites. In terms of oxygenation improveme nt as evaluated by AaPO(2), diuretic treatment may be superior to larg e-volume paracentesis.