Study of central hemodynamics in patients with liver cirrhosis

Authors

  • A. V. Rusin Uzhhorod National University
  • O. P. Balazh Uzhhorod National University
  • N. V. Bedey Uzhhorod National University
  • O. I. Petrichko Uzhhorod National University

DOI:

https://doi.org/10.11603/2414-4533.2021.1.12017

Keywords:

liver cirrhosis, echocardiography, ultrasound diagnostics, central hemodynamics

Abstract

Materials and Methods. The study involved 95 patients with LC who were hospitalized from 2018 to 2020 in the Department of Anesthesiology and Intensive Care, Surgical and Gastroenterological Departments of the Transcarpathian Regional Clinical Hospital named after Andrii Novak (Uzhhorod). Group I (Child-Pugh class A – compensation stage) included 18 (18.95 %) patients, group II (class B – subcompensation stage) – 25 (26.3 %) patients, group III (class C), stage of decompensation) included 52 (54.7 %) patients.

To determine changes in the cardiovascular system (CVS), all patients with LC underwent ECG examination, echocardiography. The following indicators were analyzed: systolic blood pressure (SBP), diastolic blood pressure (DBP), average daily blood pressure (SBPd, DBPd), mean night blood pressure (SBPn, DBPn), day and night variability index (VI) SBP (SBPd, SBPn) and DBP (IV DBPd, IV DBP n), daily index (DI SBP, DI DBP). Types of central hemodynamics in the examined patients were defined as the ratio of the index of specific peripheral vascular resistance (PVR) in both circulatory systems and the shock index (right) ventricles according to Doppler.

Results and Discussion. In patients with LC group I shock index (SI) before treatment was (48.22±2.11) ml/m2 at (39.97±3.15) ml/m2 in the control group – p <0.05, left ventricular ejection fraction (RVLV) – (63.18±2.46) % at a rate of (68.42±2.31) % (p>0.05). While in patients of group II shock index (II) before treatment was (44.11±5.7) ml/m2 compared with group III (32.5±4.4) ml/m2 – p <0.05, the fraction of left ventricular ejection (LV EF) – (62.4±3.3) % at (60.11±3.2) in group III (norm (68.42±2.31) %; p> 0.05).

The hyperkinetic type of central hemodynamics prevailed in patients with LC with manifestations of group I (55.0 % of patients), and the normokinetic type of central hemodynamics prevailed in group II with 60.0 % of patients. A feature of the parameters of central hemodynamics for patients of group III (decompensation stage) was the appearance of hypovolemic type of circulation – in 13.0 % of patients.

In patients with LC due to central and splanchnic circulatory disorders, a characteristic feature of the systemic circulation is the formation of a hyperdynamic type of circulation. In patients of class A the hyperkinetic type prevails, in patients of class B – normokinetic type, and for patients of class C – the appearance of hypovolemic type of hemodynamics.

References

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Published

2021-04-30

How to Cite

Rusin, A. V., Balazh, O. P., Bedey, N. V., & Petrichko, O. I. (2021). Study of central hemodynamics in patients with liver cirrhosis. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (1), 18–22. https://doi.org/10.11603/2414-4533.2021.1.12017

Issue

No. 1 (2021)

Section

ORIGINAL INVESTIGATIONS

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