Cardiopulmonary response to exercise in patients with liver cirrhosis and impaired pulmonary gas exchange.

Maximal exercise capacity and pulmonary gas exchange are both commonly impaired in liver cirrhosis. Apart from rare cases of hepatopulmonary syndrome, it is still unknown whether these moderate pulmonary gas exchange abnormalities can alter aerobic capacity of cirrhotic patients. Resting pulmonary function tests and symptom-limited cardiopulmonary exercise testing were prospectively investigated in 30 patients with liver cirrhosis exhibiting a widened alveolar-arterial oxygen gradient (P(A-a)O(2) > 30 mm Hg at peak exercise) without pulmonary vascular dilatations at contrast-enhanced echocardiography.

Determinants of dyspnea and alveolar hypoventilation during exercise in cystic fibrosis: impact of inspiratory muscle endurance.

Unlabelled: Dyspnea is one of the main complaints of patients with cystic fibrosis (CF). Lung function at rest is not sufficient to explain dyspnea during exercise. Because inspiratory muscles are faced with an increased workload in advanced CF, we studied the impact of their strength and endurance on dyspnea and alveolar hypoventilation during exercise.

Aerobic capacity in patients with chronic liver disease: Very modest effect of liver transplantation.

Introduction: Aerobic capacity is commonly impaired in patients with liver cirrhosis, as demonstrated by their low oxygen consumption at peak exercise (peak VO(2)). This impairment is correlated with the severity of the liver disease. We investigated the effect of orthotopic liver transplantation (OLT) alone on exercise capacity in this prospective study of patients with liver cirrhosis.

Impact of impaired aerobic capacity on liver transplant candidates.

Background: Oxygen consumption at peak exercise (peak VO2) is the most accurate index of aerobic capacity (AC), which reflects the physical condition of an individual and is currently considered the gold standard for cardiorespiratory fitness. Evaluation of peak VO2 to identify high-risk candidates for liver transplantation (LT) may represent an interesting approach. The aims of this study were (a) to describe AC and identify factors independently associated with peak VO2; (b) to analyze the prognostic value of peak VO2 in patients referred for preliminary evaluation of LT; and (c) to provide preliminary data on the influence of peak VO2 on length of hospitalization and the need for oxygen support after LT.

Dobutamine and gastric-to-arterial carbon dioxide gap in severe sepsis without shock.

Objectives: To evaluate the effect of an early dobutamine infusion on gastrointestinal perfusion in patients with severe sepsis.

Design: Prospective, randomized, controlled, multicenter clinical study.

Setting: Six medical and/or surgical intensive care units (ICU) of teaching hospitals.