Dyspnea and respiratory muscle strength in end-stage liver disease

doi:10.4254/wjh.v5.i2.56

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Feb 27, 2013 (publication date) through Nov 9, 2024

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World Journal of Hepatology

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1948-5182

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Hepatol. Feb 27, 2013; 5(2): 56-63
Published online Feb 27, 2013. doi: 10.4254/wjh.v5.i2.56

Table 1 Anthropometric characteristics and routine respiratory function data of 40 end-stage liver disease patients, stratified in two groups according to the presence or absence of ascites

	All patients (n = 40)	Ascites (n = 17)	Non-ascites (n = 23)	P value
Gender, M/F	29/11	15/2	14/9	0.079
Age, yr	52 ± 10	51 ± 10	52 ± 9	0.752
Ht, m	1.69 ± 0.90	1.73 ± 0.90	1.66 ± 0.90	0.015
BMI, kg ∙ m^-2	28 ± 4	26 ± 4	29 ± 5	0.144
Pack- years, yr	19 ± 22	27 ± 25	13 ± 18	0.087¹
FVC	104 ± 20	91 ± 17	114 ± 16	< 0.001
FEV₁	100 ± 18	89 ± 15	108 ± 15	< 0.001
FEV₁/FVC, %	78 ± 3	79 ± 3	78 ± 3	0.083
PEF	95 ± 19	84 ± 18	103 ± 17	0.002
TLC	95 ± 20	86 ± 16	102 ± 21	0.011
FRC	97 ± 28	87 ± 24	101 ± 29	0.136
RV	92 ± 28	91 ± 25	93 ± 30	0.840
DL_CO	78 ± 18	70 ± 16	84 ± 18	0.013

¹Mann-Whitney rank sum test was used. Values are mean ± SD obtained in a sitting position. Unless otherwise specified, values are expressed as % of predicted. Statistical significance tested with Student’s t test between ascites and non-ascites groups. M: Male; F: Female; Ht: Height; BMI: Body mass index; FVC: Forced vital capacity; FEV₁: Forced expiratory volume in one second; PEF: Peak expiratory flow; TLC: Total lung capacity; FRC: Functional residual capacity; RV: Residual volume; DL_CO: Diffusing capacity for carbon monoxide.

Table 2 Serum laboratory data of the 40 patients with end-stage liver disease stratified according to the presence or absence of ascites

	All patients (n = 40)	Ascites (n = 17)	Non-ascites (n = 23)	P value
INR	1.40 ± 0.31	1.53 ± 0.34	1.30 ± 0.25	0.017¹
Haemoglobin, g/L	121.00 ± 23.80	108.60 ± 24.00	130.10 ± 19.20	0.003
Creatinine, mg/dL	1.19 ± 1.02	1.43 ± 1.49	1.01 ± 0.39	0.328¹
Total protein, g/L	72.20 ± 8.70	68.80 ± 8.80	74.70 ± 7.90	0.032
Albumin, g/L	34.80 ± 6.70	32.00 ± 6.90	37.00 ± 5.90	0.019
Total bilirubin, mg/dL	4.67 ± 9.61	6.68 ± 11.41	3.19 ± 7.97	0.004¹
Sodium, mmol/L	137.00 ± 5.00	134.00 ± 5.00	139.00 ± 4.00	< 0.001

Values obtained maximum ± 7 d of respiratory tests day.

¹Mann-Whitney rank sum test was used. Statistical significance tested with Student’s t test between ascites and non-ascites groups. INR: International normalised ratio for prothrombin time.

Table 3 Comparison of model for end-stage liver disease score, modified medical research council dyspnea score, and respiratory muscle strength indices between ascites and non-ascites liver disease patients

	All patients (n = 40)	Ascites (n = 17)	Non-ascites (n = 23)	P value
MELD	14 ± 6	17 ± 7	12 ± 5	0.006¹
mMRC	2.0 ± 1.2	2.2 ± 1.1	1.9 ± 1.2	0.444¹
Pemax, %pred	105 ± 35	87 ± 30	118 ± 33	0.004
Pimax, %pred	90 ± 29	72 ± 20	103 ± 28	< 0.001
RMS, %pred	97 ± 30	79 ± 23	110 ± 28	< 0.001

Values are mean ± SD obtained in a sitting position. Statistical significance tested with Student’s t test between ascites and non-ascites groups.

¹For MELD and mMRC Mann-Whitney rank sum test was used. MELD: Model for end-stage liver disease; mMRC: Modified medical research council; Pemax: Maximum static expiratory mouth pressure; %pred: Percent of predicted; Pimax: Maximum static inspiratory mouth pressure; RMS: Respiratory muscle strength.

Table 4 Arterial blood gases and pattern of breathing of 40 end-stage liver disease patients, according to presence or absence of ascites

	All patients (n = 40)	Ascites (n = 17)	Non-ascites (n = 23)	P value
pH	7.49 ± 0.04	7.50 ± 0.04	7.48 ± 0.04	0.216
PaO₂, kPa	12.3 ± 1.3	12.0 ± 1.5	12.3 ± 1.3	0.508
PaCO₂, kPa	4.4 ± 0.5	4.3 ± 0.5	4.5 ± 0.4	0.261
V_E, L/min	11.5 ± 3.5	12.7 ± 3.2	10.6 ± 3.5	0.065
V_T, L	0.735 ± 0.287	0.800 ± 0.255	0.686 ± 0.305	0.218
T_E, s	2.26 ± 0.70	2.25 ± 0.68	2.26 ± 0.74	0.953
T_I, s	1.64 ± 0.40	1.65 ± 0.40	1.64 ± 0.42	0.941
RR, bpm	16 ± 4	17 ± 5	16 ± 4	0.938
V_T/T_I, L/s	0.449 ± 0.129	0.496 ± 0.130	0.414 ± 0.119	0.044
T_I/T_TOT	0.43 ± 0.05	0.43 ± 0.06	0.42 ± 0.05	0.928

Values are obtained in a sitting position. Statistical significance tested with Student’s t test between ascites and non-ascites groups. PaO₂: Arterial oxygen tension; PaCO₂: Arterial carbon dioxide tension; V_E: Minute ventilation; V_T: Tidal volume; T_E: Duration of expiration; T_I: Duration of inspiration; RR: Respiratory rate; bpm: Breaths per minute; T_TOT: Total cycle duration; V_T/T_I: Mean inspiratory flow; T_I/T_TOT: Duty cycle.

Citation: Kaltsakas G, Antoniou E, Palamidas AF, Gennimata SA, Paraskeva P, Smyrnis A, Koutsoukou A, Milic-Emili J, Koulouris NG. Dyspnea and respiratory muscle strength in end-stage liver disease. World J Hepatol 2013; 5(2): 56-63
URL: https://www.wjgnet.com/1948-5182/full/v5/i2/56.htm
DOI: https://dx.doi.org/10.4254/wjh.v5.i2.56