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Updated: Apr 11, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
Published on: August 1, 2018
Acid-base disturbance in patients with cirrhosis: relation to hemodynamic dysfunction
Jens H Henriksen1, Flemming Bendtsen, Søren Møller
1aDepartment of Clinical Physiology and Nuclear Medicine bGastro Unit, Medical Division, Hvidovre Hospital, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Purpose:
Acid-base disturbances were investigated in patients with cirrhosis in relation to hemodynamic derangement to analyze the hyperventilatory effects and the metabolic compensation.
Methods:
A total of 66 patients with cirrhosis and 44 controls were investigated during a hemodynamic study.
Results:
Hyperventilatory hypocapnia was present in all patients with cirrhosis and progressed from Child class A to C (P<0.01). Arterial pH increased significantly from class A to C (P<0.001) and was correlated inversely to the mean arterial blood pressure (r=-0.30, P<0.02), systemic vascular resistance (r=-0.25, P<0.05), indocyanine green clearance (r=-0.37, P<0.005), and serum sodium (r=-0.38, P<0.002). Metabolic compensation was shown by a reduced standard base excess in all patients (P<0.001). Standard base excess contained elements related to changes in serum albumin, water dilution, and effects of unidentified ions (all P<0.001). A significant hepatic component in the acid-base disturbances could not be identified.
Conclusion:
Hypocapnic alkalosis is related to disease severity and hyperdynamic systemic circulation in patients with cirrhosis. The metabolic compensation includes alterations in serum albumin and water retention that may result in a delicate acid-base balance in these patients.
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