Prevalence of hypoxemia in 102 Japanese patients with alcoholic and nonalcoholic cirrhosis

OBJECTIVE: Liver cirrhosis is often accompanied by arterial hypoxemia in th e absence of cardiopulmonary disease. The aim of this study was to investig ate the relationship between various clinicopathological conditions and the hypoxemia seen in Japanese patients with liver cirrhosis. METHODS: In 102 consecutive patients with alcoholic (N = 45) and nonalcohol ic (N = 57 cirrhosis not associated with cardiopulmonary disease, we perfor med lung perfusion scintigraphy, contrast echocardiography, and arterial bl ood gas analysis and measured oxygen consumption. RESULTS: No abnormality was seen in pulmonary blood flow in cirrhotic patie nts, but 38 (38%) of them had a decreased partial pressure of oxygen (PaO2) . The hypoxemic patients did not show any pulmonary signs or symptoms. The hypoxemia was not: associated with the Child-Pugh grade, and was observed i n 32 (71%) of the 45 alcoholic patients but in only six (11%) of the 57 non alcoholic patients (p < 0.001). Oxygen consumption was sig nificantly highe r in the alcoholic group than in the nonalcoholic group (p < 0.0001), and a high incidence of oxygen consumption was seen in all 45 (100%) of the alco holic patients and in 34 (60%) of the nonalcoholic subjects, the difference being significant (p < 0.01). The relationship between oxygen consumption and PaO2 in the 102 cirrhotic patients showed an inverse correlation (r = - 0.85, p < 0.0001). Among the alcoholic patients, the incidence of hypoxemia did not differ between the 33 smokers and the 22 nonsmokers. After 1 wk of abstinence from alcohol a significant increase (p < 0.0001) in the PaO2 wa s seen in 14 of 19 patients with alcoholic cirrhosis. CONCLUSIONS: We conclude that the hypoxemia in Japanese patients with liver cirrhosis occurs mainly in drinking alcoholic patients, presumably due to an increased oxygen consumption by alcohol. (C) 1999 by Am. Coll. of Gastro enterology.