ENDOGENOUS NITRIC-OXIDE IN EXHALED AIR FROM PATIENTS WITH LIVER-CIRRHOSIS

Background: The aim of this study was to investigate the potential eff ects of liver insufficiency on nitric oxide concentrations in exhaled air. Methods: Nitric oxide concentrations in the exhaled air from 13 p atients with liver cirrhosis and 11 healthy control subjects was exami ned by the single-breath technique. Results: There was a clear correla tion between Child-Pugh score and NO in exhaled air (peak after 15 sec of breathholding, R = 0.623, P = 0.023). Similarly, there were signif icant correlations in peak NO concentrations and alkaline phosphatase, bilirubin, aspartate and alanine aminotransferase, and albumin. The m ost severely ill patient in our study had the highest NO concentration s in her exhaled air. On recovery from her liver illness the concentra tion of NO in her exhaled air decreased. There was no correlation betw een circulating levels of the endogenous NO synthase inhibitors asymme tric and symmetric N-G,N-G-dimethyl-arginine and exhaled NO concentrat ions. Conclusions: The present data show a correlation between endogen ous NO formation in the respiratory system and liver dysfunction. This might contribute to the understanding of the pathophysiology in pulmo nary vasodilatation in liver disease.