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[Pulmonary complications in hepatic coma].

A Laggner, G Kleinberger, J Haller

    Leber, Magen, Darm
    |October 1, 1982
    PubMed
    Summary
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    Pulmonary complications are frequent in patients with hepatic coma, significantly increasing mortality. Intensive care unit (ICU) treatment requires improvement to reduce these life-threatening events.

    Area of Science:

    • Pulmonary Medicine
    • Hepatology
    • Critical Care Medicine

    Context:

    • Hepatic coma, encompassing acute liver failure and hepatic encephalopathy, presents significant challenges in patient management.
    • Pulmonary complications are a recognized but often underestimated concern in patients with severe liver disease.

    Purpose:

    • To retrospectively evaluate the incidence and extent of pulmonary complications in patients with hepatic coma.
    • To analyze the impact of pulmonary complications on mortality rates.
    • To explore potential pathogenetic mechanisms and identify areas for improvement in intensive care.

    Summary:

    • A retrospective study of 101 hepatic coma patients revealed a high incidence (73.3%) of pulmonary complications, including pulmonary edema, pneumonia, and tracheobronchitis.

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  • Patients with pulmonary complications exhibited a significantly higher lethality rate (97%) compared to those without (16%).
  • Potential causes include central mechanisms, vascular lesions, cardiac failure, infection, and intrapulmonary shunts, particularly in cases of respiratory failure without morphological lung changes.

    • Impact:

    • Highlights the critical need for improved intensive care unit (ICU) strategies to mitigate pulmonary complications in hepatic coma patients.
    • Suggests that the observed 2.4-fold increase in pulmonary complications during ICU treatment indicates a need for enhanced patient care protocols.
    • Emphasizes the link between pulmonary complications and mortality, underscoring the importance of early detection and management in improving patient outcomes.