Influence of transjugular intrahepatic portosystemic shunts (TIPS) on tissue oxygenation in patients with cirrhosis

ABSTRACT— Aims/Backgrounds: The aim of this prospective study was to evaluate the influence of transjugular portosystemic intrahepatic shunts (TIPS) on tissue oxygenation in patients with cirrhosis and refractory ascites. Methods: Five shunted patients were included in the study. The blood and tissue oxygenation values were analyzed 12 days and 4 months after TIPS procedure. The results were compared with those observed in patients treated by paracentesis. Results: Unlike patients treated by paracentesis, PaO₂ values remained unchanged throughout follow-up in shunted patients. After the TIPS procedure, there was a transient increase in systemic O₂ transport and O₂ uptake and a transient decrease in O₂ saturation of hepatic oxyhemoglobin. After 4 months, TIPS resulted in an increase in PCO₂ values and bicarbonate concentrations. Conclusions: The TIPS procedure seems to prevent the decrease in PaO₂ observed in patients treated by paracentesis and may improve the respiratory alkalosis of cirrhosis.