Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Davis, H. H.
Right arrow Articles by Schainker, B. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Davis, H. H., 2d
Right arrow Articles by Schainker, B. A.

Chest, Vol 73, 507-511, Copyright © 1978 by American College of Chest Physicians

ARTICLES

Alveolar-capillary oxygen disequilibrium in hepatic cirrhosis

HH Davis 2d, DJ Schwartz, SS Lefrak, N Susman and BA Schainker

Hypoxemia is a frequent occurrence in patients with severe hepatic disease. Multiple mechanisms have been implicated in the production of such hypoxemia. The case of a 35-year-old man with cyanosis, clubbing, and cirrhosis is presented. Physiologic data from this patient revealed normal pulmonary function, except for a low diffusing capacity and a 28 percent shunt while the patient was breathing 100 percent oxygen. A perfusion scan with radioactive 99mtechnetium-labelled macroaggregated albumin revealed 67 percent of the labelled macroaggregated albumin in the systemic circulation. Post-mortem examination demonstrated normal pulmonary parenchyma, markedly dilated intraparenchymal capillaries and arterioles, subpleural angiomata, and cirrhosis. No anatomic arteriovenous connections were demonstrated before or after death. We conclude that the arterial hypoxemia of some patients with hepatic cirrhosis results from dilated gas-exchanging blood vessels. These widened vessels prevent end pulmonary capillary oxygen tension from reaching equilibrium with alveolar gas, perhaps because of the widened distance for diffusion.


This article has been cited by other articles:


Home page
 Eur Respir JHome page
J. M. B. Hughes
The hepatopulmonary syndrome: NO way out?
Eur. Respir. J., January 1, 2005; 25(1): 211 - 212.
[Full Text] [PDF]

Home page
 J. Physiol.Home page
M. K Stickland, R. C Welsh, M. J Haykowsky, S. R Petersen, W. D Anderson, D. A Taylor, M. Bouffard, and R. L Jones
Intra-pulmonary shunt and pulmonary gas exchange during exercise in humans
J. Physiol., November 15, 2004; 561(1): 321 - 329.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
M. W. Eldridge, J. A. Dempsey, H. C. Haverkamp, A. T. Lovering, and J. S. Hokanson
Exercise-induced intrapulmonary arteriovenous shunting in healthy humans
J Appl Physiol, September 1, 2004; 97(3): 797 - 805.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. Teramoto, T. Ishii, Y. Ouchi, A. Chaouat, E. Weitzenblum, and R. Schott
The Mechanism of Hypoxemia in Liver Disease With Pulmonary Hypertension
Chest, February 1, 2000; 117(2): 614 - 615.
[Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
P. A. Lange and J. K. Stoller
The Hepatopulmonary Syndrome
Ann Intern Med, April 1, 1995; 122(7): 521 - 529.
[Abstract] [Full Text]

Home page
 NEJMHome page
G. Rolla, C. Bucca, and L. Brussino
Methylene Blue in the Hepatopulmonary Syndrome
N. Engl. J. Med., October 20, 1994; 331(16): 1098 - 1098.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1978 by the American College of Chest Physicians.