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Relationship between oxygen transport and oxygen uptake in patients with cirrhosis: Effects of vasoactive drugs
Author(s) -
Moreau Richard,
Lee Samuel S.,
Hadengue Antoine,
Ozier Yves,
Sicot Christian,
Lebrec Didier
Publication year - 1989
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840090314
Subject(s) - vasoactive , oxygen transport , oxygen , cirrhosis , pharmacology , medicine , chemistry , cardiology , organic chemistry
To elucidate the relationship between oxygen transport and uptake in cirrhosis, we studied the effects of three vasoactive drugs that change O 2 transport. Systemic hemodynamics, blood gases and lactate concentration were measured in patients with alcoholic cirrhosis before and after intravenous dobutamine, propranolol and nitroglycerin. Nine patients received successively dobutamine and then propranolol. Ten patients received nitroglycerin. Three other patients without cirrhosis (controls) received dobutamine. In patients with cirrhosis, dobutamine infusion was accompanied by a significant increase in cardiac output (+21%), systemic O 2 transport (+21%) and O 2 uptake (+12%), whereas O 2 extraction ratio and arterial lactate concentration did not change significantly. Propranolol administration was followed by a significant decrease in cardiac output (−24%) and systemic O 2 transport (−25%) and a significant increase in O 2 extraction ratio (+19%), whereas O 2 uptake and arterial lactate concentration did not change. Nitroglycerin infusion was accompanied by a significant decrease in cardiac output (−21%), systemic O 2 transport (−26%) and O 2 uptake (−10%), whereas O 2 extraction ratio (+18%) and arterial lactate concentration (+31%) significantly increased. In control patients, dobutamine infusion was accompanied by an increase in cardiac output and in systemic O 2 transport and by a decrease in O 2 extraction ratio, whereas O 2 uptake was not modified. These results suggest that O 2 uptake may be abnormally dependent on O 2 transport in patients with cirrhosis.