AIM:To investigate the prevalence of chronic dyspnea and its relationship to respiratory muscle function in end-stage liver disease.METHODS:Sixty-eight consecutive,ambulatory,Caucasian patients with end-stage liver di...AIM:To investigate the prevalence of chronic dyspnea and its relationship to respiratory muscle function in end-stage liver disease.METHODS:Sixty-eight consecutive,ambulatory,Caucasian patients with end-stage liver disease,candidates for liver transplantation,were referred for preoperative respiratory function assessment.Forty of these(29 men) were included in this preliminary study after applying strict inclusion and exclusion criteria.Seventeen of 40 patients(42%) had ascites,but none of them was cachectic.Fifteen of 40 patients(38%)had a history of hepatic encephalopathy,though none of them was symptomatic at study time.All patients with a known history and/or presence of co-morbidities were excluded.Chronic dyspnea was rated according to the modified medical research council(mMRC) 6-point scale.Liver disease severity was assessed according to the Model for end-stage liver disease(MELD).Routine lung function tests,maximum static expiratory(Pemax) and inspiratory(Pimax) mouth pressures were measured.Respiratory muscle strength(RMS) was calculated from Pimax and Pemax values.In addition,arterial blood gases and pattern of breathing(VE:minute ventilation;VT:tidal volume;VT/TI:mean inspiratory flow;TI:duration of inspiration) were measured.RESULTS:Thirty-five(88%) of 40 patients aged(mean ± SD) 52 ± 10 years reported various degrees of chronic dyspnea(mMRC),ranging from 0 to 4,with a mean value of 2.0 ± 1.2.MELD score was 14 ± 6.Pemax,percent of predicted(%pred) was 105 ± 35,Pimax,%pred was 90 ± 29,and RMS,%pred was 97 ± 30.These pressures were below the normal limits in 12(30%),15(38%),and 14(35%) patients,respectively.Furthermore,comparing the subgroups of ascites to non-ascites patients,all respiratory muscle indices measured were found significantly decreased in ascites patients.Patients with ascites also had a significantly worse MELD score compared to non-ascites ones(P = 0.006).Significant correlations were found between chronic dyspnea and respiratory muscle function indices in all patients.Specific展开更多
文摘AIM:To investigate the prevalence of chronic dyspnea and its relationship to respiratory muscle function in end-stage liver disease.METHODS:Sixty-eight consecutive,ambulatory,Caucasian patients with end-stage liver disease,candidates for liver transplantation,were referred for preoperative respiratory function assessment.Forty of these(29 men) were included in this preliminary study after applying strict inclusion and exclusion criteria.Seventeen of 40 patients(42%) had ascites,but none of them was cachectic.Fifteen of 40 patients(38%)had a history of hepatic encephalopathy,though none of them was symptomatic at study time.All patients with a known history and/or presence of co-morbidities were excluded.Chronic dyspnea was rated according to the modified medical research council(mMRC) 6-point scale.Liver disease severity was assessed according to the Model for end-stage liver disease(MELD).Routine lung function tests,maximum static expiratory(Pemax) and inspiratory(Pimax) mouth pressures were measured.Respiratory muscle strength(RMS) was calculated from Pimax and Pemax values.In addition,arterial blood gases and pattern of breathing(VE:minute ventilation;VT:tidal volume;VT/TI:mean inspiratory flow;TI:duration of inspiration) were measured.RESULTS:Thirty-five(88%) of 40 patients aged(mean ± SD) 52 ± 10 years reported various degrees of chronic dyspnea(mMRC),ranging from 0 to 4,with a mean value of 2.0 ± 1.2.MELD score was 14 ± 6.Pemax,percent of predicted(%pred) was 105 ± 35,Pimax,%pred was 90 ± 29,and RMS,%pred was 97 ± 30.These pressures were below the normal limits in 12(30%),15(38%),and 14(35%) patients,respectively.Furthermore,comparing the subgroups of ascites to non-ascites patients,all respiratory muscle indices measured were found significantly decreased in ascites patients.Patients with ascites also had a significantly worse MELD score compared to non-ascites ones(P = 0.006).Significant correlations were found between chronic dyspnea and respiratory muscle function indices in all patients.Specific
