Title: A Study on Acid Base Disorders in Acute Hepatic Failure
Authors: Abhinandya Mukhopadhyay, R.K. Das
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.164
Abstract
Introduction: Alongside the kidneys and lungs, the liver has been recognized as an important regulator of acid-base homeostasis. The most common acid-base disorder with liver disorder is respiratory alkalosis. However, metabolic alkalosis, respiratory acidosis, metabolic acidosis all can be seen.
Objectives: To determine whether the acid-base state is destabilized in critically ill patients with cirrhosis and whether this is associated with mortality.
Materials and Methods: A prospective analytical study from July 2016 to July 2017 was done including 50 patients admitted in medical intensive care unit in Darbhanga Medical College and Hospital with hepatic failure. Patients with history of concomitant other drug or alcohol consumption, known history of cardiac, respiratory, renal disorder, any neurological disease, infectious disease, Known cirrhosis were excluded. Clinical, demographic, biochemical data were collected. Patients were followed till intensive care unit stay or death. All data were analysed using appropriate statistical test.
Results: Abnormality in blood pH was noted in 35(70%) patients. Alkalosis was commonest finding (40%) followed by acidosis (30%). Blood lactate was significantly higher and blood pH was significantly lower in non survivors in comparison to survivors.
Conclusion: Various complex metabolic acid-base disorders may occur with liver dysfunction. When patients with liver cirrhosis become critically ill metabolic acidosis may ensue. Thus, further research regrding pathophysiology and prognostic importance of various acid-base disturbances in patients with liver disease is necessary.
