الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
This work was conducted on 30 patients of liver cirrhosis
(compensated and decompensated) and 10 healthy age- and sex matched control subjects.
According to modified Child-Pugh classification for cirrhosis, patients are classified into 3 groups:
•Group A included 8 patients with child class A.
•Group B included 6 patients with child class B.
•Group C included 16 patients with child class C.
The objective of the present work was to study the changes in
blood gases in cirrhotic patients and if oxygen therapy is needed as a routine in hypoxaemic patients.
For this purpose, all patients were subjected to the following:
•Thorough history taking.
•Meticulous clinical examination.
■Full investigations including:
- Complete urine and stool analysis.
- Complete blood count.
- Renal function tests.
- Liver function tests including:
•Serum bilirubin.
•SGOT, SGPT and serum alkaline phosphatase.
•Serum protein and albumin.
•Prothrombin activity.
Serological tests for viral hepatitis markers.
•HbsAg, H13gAb & HBeAg.
•HCV-Ab.
■Abdominal ultrasonography.
■Rectal snip.
■Chest x-ray.
•Liver biopsy in some patients.
■Pulmonary function tests.
•Arterial blood gases.
The present study revealed that mild arterial hypoxaemia was present in 20% of cirrhotic patients with significant difference between patient and control groups and it was correlated significantly with severity of liver disease according to modified Child Pugh classification of cirrhosis. Also arterial hypoxaemia was correlated significantly with S. albumin, S. bilirubin, prothrombin time and HB%. Finger clubbing and cutaneous spider nevi were an important indicator for blood gases exchange abnormalities and arterial hypoxaemia in cirrhotic patients.
There was a significant correlation between arterial hypoxaemia and schistosomal infection. Pulmonary function tests were significantly reduced in hypoxaemic patients. Low flow oxygen supplementation increased PO2 in hypoxaemic patients but insignificantly, so didn’t yet correct hypoxaemia, this result reflects the hypothesis that microvascular abnormalities plays an important role in pathogenesis of arterial hypoxaemia in liver cirrhosis. Hypocapnia was frequent in cirrhotic patients and had highly significant correlation with the severity of liver disease. Respiratory alkalosis was insignificant in patients groups compared to control. Pulmonary function tests were significantly reduced in patients with liver cirrhosis and correlated significantly with Pugh score. Also there was a significant correlation between schistosomal infection and pulmonary function tests that showed mild restrictive
pattern.