Objective: To determine if nitric oxide output in exhaled air is increased in patients with liver cirrhosis.
Design: Cross-sectional study.
Setting: A university hospital.
Patients: 50 patients with liver cirrhosis, 6 patients with chronic hepatitis, and 15 healthy controls.
Measurements: Nitric oxide in exhaled air was measured using a chemiluminescence analyzer. Cardiac index was determined using echocardiography.
Results: Patients with decompensated liver cirrhosis had higher levels of exhaled nitric oxide output (Child C patients, 190 +/- 11 nL/min per m2 body surface area) than controls (97 +/- 8 nL/min per m2 body surface area; P < 0.001), whereas patients with compensated liver cirrhosis or chronic hepatitis had levels of nitric oxide output similar to those found in controls. Cardiac index was greater in patients with liver cirrhosis (Child C patients, 4.3 +/- 0.3 L/min per m2 body surface area) than in controls (2.9 +/- 0.2 L/min per m2 body surface area; P < 0.001). Cardiac index correlated with nitric oxide levels (r = 0.621; P < 0.001).
Conclusions: Increased nitric oxide output in exhaled air is associated with systemic circulatory disturbances in patients with liver cirrhosis.