Document Detail


Effects of propranolol on arterial oxygenation and oxygen transport to tissues in patients with cirrhosis.
MedLine Citation:
PMID:  2382894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with cirrhosis may show ventilation-perfusion (VA/Q) inequality in the absence of any intrinsic heart or lung disease. However, the high cardiac output of cirrhosis generally prevents or minimizes the appearance of a severe degree of arterial hypoxemia. Propranolol has been used to reduce cardiac output and portal pressure in these patients. We wondered whether it might alter arterial oxygenation and reduce O2 transport to tissues. We studied eight patients (three women) 54 +/- 3 (SEM) yr of age before and after intravenous propranolol (0.1 mg/kg followed by 2 mg/h). Cardiac output (QT) fell from 7.8 +/- 0.7 to 6.0 +/- 0.7 L/min (p less than 0.05), and portal pressure was reduced (22 +/- 2 to 19 +/- 2 mm Hg, p less than 0.01). Arterial PO2 did not change (88 +/- 4 to 89 +/- 5 mm Hg) because the fall in mixed venous PO2 (43 +/- 1 to 40 +/- 1 mm Hg, p less than 0.01) that followed the lower QT was counterbalanced by a lower intrapulmonary shunt (multiple inert gas technique) (4 +/- 2 to 2 +/- 1%, p less than 0.05) and a shift of the VA/Q distributions toward a higher VA/Q ratio. Paralleling the fall in QT, oxygen transport to tissues (QO2) was reduced (19 +/- 2 to 14 +/- 1 ml/min/kg, p less than 0.01). However, O2 uptake (VO2) remained constant (3.4 +/- 0.2 to 3.6 +/- 0.2 ml/min/kg) because O2 extraction by the tissues increased appropriately (22 +/- 2 to 28 +/- 1%, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A G Agusti; J Roca; J Bosch; J C Garcia-Pagan; P D Wagner; R Rodriguez-Roisin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  142     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1990-09-11     Completed Date:  1990-09-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  306-10     Citation Subset:  AIM; IM; S    
Affiliation:
Servei de Pneumologia Hospital, Universitat de Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Female
Hemodynamics / drug effects*
Humans
Hypertension, Portal / physiopathology
Liver Cirrhosis / physiopathology*
Male
Middle Aged
Oxygen / blood
Propranolol / pharmacology*
Pulmonary Gas Exchange / drug effects*
Ventilation-Perfusion Ratio / drug effects*
Chemical
Reg. No./Substance:
525-66-6/Propranolol; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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