Can non-invasive measurements aid clinical assessment of volume in patients with cirrhosis?

doi:10.4254/wjh.v5.i8.433

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 5, Issue 8

This Article

Academic Content and Language Evaluation of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (5868)

All Articles published online

The chart showing PDF series, HTML series, Tables (1-5) series.

Item

Count

PDF

492

HTML

3139

Tables (1-5)

143

Sum=3774

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

1084

Download

1010

Sum=2094

Aug 27, 2013 (publication date) through Apr 25, 2024

Times Cited of This Article

Times Cited (38)

Journal Information of This Article

Publication Name

World Journal of Hepatology

ISSN

1948-5182

Publisher of This Article

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

Brief Article

World J Hepatol. Aug 27, 2013; 5(8): 433-438
Published online Aug 27, 2013. doi: 10.4254/wjh.v5.i8.433

Table 1 Demographics and standard biochemistry and haematology results in the stable cirrhotic and the acutely decompensated cirrhotic patients

	Compensated	Decompensated
Age (yr)	53.4 ± 1.5	53.9 ± 2.7
Male sex	60%	64%
Weight (kg)	75.2 ± 1.9	76.1 ± 3.2
Sodium (mmol/L)	135.8 ± 1.4	135.9 ± 1.3
Urea (mmol/L)	4.8 (3.4-6.7)	6.1 (2.9-13.4)
Creatinine (μmol/L)	70 (48-81)	65 (45-116)
Albumin (g/L)	32 (31-40.5)	30 (27-33)^b
Bilirubin (μmol/L)	36.5 (21-98)	41 (27.5-100.5)
ALT (U/L)	44 (26-55)	31 (19-51)
AST (U/L)	65 (44-98)	63 (46-112)
GGT (U/L)	63 (30-188)	118 (41-263)
ALP (U/L)	117.8 ± 9.4	132.7 ± 14.8
Haemoglobin (g/L)	119 ± 6	101 ± 2^a
WBC (× 10⁹/L)	5.31 ± 0.4	9.5 ± 1.5^a
Platelets (× 10⁹/L)	92.5 (57.5-134)	84 (53.5-143)
INR	1.58 ± 0.11	1.72 ± 0.08
aPTT s	36.7 ± 2.9	36.3 ± 1.6
Cortisol (μmol/L)	361 (180-483)	361 (208-611)
Synacthen 30 min cortisol (μmol/L)	614 (411-719)	518 (399-767)

Results expressed as mean ± SE, or as percentage, or median (interquartile range).

^aP < 0.05,

^bP < 0.01 vs compensated cirrhotic group. ALT: Alanine aminotranferease; AST: Aspartate aminotransferase; GGT: Gamma glutamyl transpeptidase; ALP: Alkaline phosphatase; WBC: White blood cells; INR: International normalized ratio.

Table 2 Blood pressure and echocardiographic findings in stable cirrhotic and the acutely decompensated cirrhotic patients

	Compensated	Decompensated
Systolic blood pressure (mmHg)	122.4 ± 5.3	101.8 ± 4.3^b
Diastolic blood pressure (mmHg)	68.8 ± 3.1	58.4 ± 4.1^a
Heart rate min^-1	74.7 ± 3.4	100.3 ± 6.7^b
Right atrial pressure (mmHg)	6.1 ± 0.5	5.0 ± 0.1
Ejection fraction (%)	59.1 ± 1.0	59.6 ± 0.9
RVESP (mmHg)	31.1 ± 2.3	32.2 ± 2.5
PVFV (m/s)	1.24 ± 0.1	1.22 ± 0.1
LVEDV (mL)	165.5 ± 10.3	149.9 ± 12.9
Vaortic (m/s)	1.54 ± 0.06	1.60 ± 0.09

Right ventricular end systolic pressure (RVESP) normal, 25 mmHg, pulmonary valve flow velocity (PVFV), left ventricular end diastolic volume (LVEDV) normal 78-128 mL, aortic valve flow velocity (Vaortic). Results expressed as mean ± SE,

^aP < 0.05,

^bP < 0.01 vs compensated cirrhotic group.

Table 3 Multi-frequency bioelectrical impedance analysis data in the stable cirrhotic and the acutely decompensated cirrhotic patients

	Compensated	Decompensated
Total body water ICW (L)	39.2 ± 1.9	40.7 ± 1.9
ICW (L)	23.6 ± 1.2	23.9 ± 1.1
ECW (L)	15.7 ± 0.7	16.8 ± 0.8
Total body ECW/TBW	0.399 ± 0.004	0.412 ± 0.003
R arm ECW/TBW	0.385 ± 0.001	0.388 ± 0.002
L arm ECW/TBW	0.386 ± 0.002	0.387 ± 0.003
Trunk ECW/TBW	0.404 ± 0.005	0.420 ± 0.004^a
R leg ECW/TBW	0.398 ± 0.003	0.410 ± 0.003^a
L leg ECW/TBW	0.399 ± 0.003	0.412 ± 0.003^a

Mean extracellular water (ECW)/total body water (TBW) ratio for total body, limb and trunk value in normal healthy humans 0.38 (95% confidence limits 0.36-0.4). Results expressed as mean ± SE,

^aP < 0.05 vs compensated cirrhotic group. ICW: Intracellular water.

Table 4 Reliability of multi-frequency bioelectrical impedance assessments

Assessment	1^st	2^nd	3^rd
%ECW/TBW	40.7 ± 0.26	40.8 ± 0.21	40.8 ± 0.22
Bias (95%CI)	0.14 (-0.16-0.44)	0.12 (-0.23-0.46)	-0.03 (-0.16-0.00)
Pearson r	0.81	0.77	0.96
Pearson P	< 0.001	< 0.001	< 0.001

Results expressed as mean ± SE, comparison by Bland Altman bias with 95%CI and Pearson correlation. 1^st assessment vs 2^nd and 3^rd, and 2^ndvs 3^rd. ECW: Extracellular water; TBW: Total body water.

Table 5 Multi-frequency bioelectrical impedance analysis measurements in those patients with no clinically detectable ascites those patients with moderate to severe ascites judged clinically

	No ascites	Moderate/severe ascites
Weight (kg)	75.1 ± 3.9	75.4 ± 3.0
Total body water (L)	39.4 ± 1.8	37.9 ± 1.9
ICW (L)	23.71 ± 0.66	22.29 ± 1.12
ECW (L)	15.66 ± 0.66	15.65 ± 0.76
Total body ECW/TBW	0.399 ± 0.004	0.413 ± 0.003^a
R arm ECW/TBW	0.384 ± 0.002	0.386 ± 0.002
L arm ECW/TBW	0.385 ± 0.0021	0.385 ± 0.003
Trunk ECW/TBW	0.403 ± 0.005	0.421 ± 0.003^a
R leg ECW/TBW	0.398 ± 0.004	0.410 ± 0.003^a
L leg ECW/TBW	0.400 ± 0.004	0.413 ± 0.003^a

Results expressed as mean ± SE,

^aP < 0.05 vs No ascites group. ICW: Intracellular water; ECW: Extracellular water; TBW: Total body water.

Citation: Davenport A, Agarwal B, Wright G, Mantzoukis K, Dimitrova R, Davar J, Vasianopoulou P, Burroughs AK. Can non-invasive measurements aid clinical assessment of volume in patients with cirrhosis? World J Hepatol 2013; 5(8): 433-438
URL: https://www.wjgnet.com/1948-5182/full/v5/i8/433.htm
DOI: https://dx.doi.org/10.4254/wjh.v5.i8.433