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KMID : 0882419770200030198
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Korean Journal of Medicine
1977 Volume.20 No. 3 p.198 ~ p.206
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Studies on pH , PO_(2) & PCO_(2) in Ascitic , Pleural or Cerebrospinal Fluids of Various Diseases
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Kim Jae-Hyung
Kim Hoon-Kyo
Kang Moon-Won
Choi Young-Kil
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Abstract
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In arterial blood and ascitic, pleural or cerebrospinal fluids of 65 patients with different diseases, pH, P02 & PCO2 were measured. The ascitic or
Pleural fluids of patients with inflammatory and malignant diseases of the peritoneum or pleura had lower levels of pH & PO2, and higher PCO2 than those of the patients with liver cirrhosis. In the patients with liver cirrhosis, the values of pH & PO2, in the ascitic fluid were higher and PCO2 were lower than those in the arterial blood. In the patients with inflammatory and malignant diseases, the ascitic or pleural fluids had lower levels of pH & P02 and higher PCO2 than those in the arterial blood. In the patients with liver cirrhosis, ascitic fluids had higher level of pH & PO2 and lower PCO2 than those in the primary hepatoma. The gas pattern of ascites in the patients with primary hepatoma, which was classified as transudate in classic transudate-exudate differentiation with LDH & protein, was considered to belong to exudate group-decreased pH & PO2 and increased PCO2. In the patients with tuberculous, meningitis, cerebrospinal fluids had lower levels of pH & P02 and higher PCO2 than those in the normal controls. During the course of liver cirrhosis, four patients developed primary, peritonitis, gas changes of ascites showed decreased pH & PO2 and increased PCO2, which returned to pre-treatment levels with adequate antibiotic therapy. During hepatic coma, pH & PO2 in ascites were increased and PCO2 decreased, after recovery from hepatic coma, gas pattern returned to pre-coma level rapidly. The changes of gas pattern in ascites during hepatic coma were more distinct than those of arterial blood (alkalotic pattern, respiratory or metabolic).
In conclusion,; firstly, gas pattern of ascites can differentiate liver cirrhosis from inflammatory or malignant diseases. Secondly, gas pattern of ascites or pleural fluids can be a new criterion for differentiating exudate and transudate. Thirdly, during the course of liver cirrhosis, gas pattern can be used as an early criterion of complicating diseases (peritonitis, hepatoma or hepatic coma). Fourthly, gas pattern of cerebrospinal fluids can differentiate tuberculous meningitis from normal controls.
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