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Khurana Sandeep - - 2010
The purpose of this study was to characterize changes in hepatic venous pressures in patients with chronic hepatitis C. The histology and laboratory data from patients with chronic hepatitis C who underwent a transjugular liver biopsy (TJLB) and hepatic venous pressure gradient measurement were analyzed. Portal hypertension was defined as ...
Chin J H - - 2010
We have described herein a 39-year-old male patient with hepatitis B virus-related cirrhosis (Child class C), showing a prolonged corrected QT interval, who developed torsades de pointes (TdP) in the neohepatic stage of liver transplantation (LT). There was no arrhythmia in the pre-anhepatic and anhepatic stages. Multiple premature ventricular complexes, ...
La Mura Vincenzo - - 2010
Hepatic venous pressure gradient (HVPG), the difference between wedge and free hepatic venous pressure, is the preferred method for estimating portal pressure. However, it has been suggested that hepatic atrial pressure gradient (HAPG)--the gradient between wedge hepatic venous pressure and right atrial pressure (RAP)--might better reflect variceal hemodynamics. The aim ...
Coelho-Prabhu Nayantara - - 2010
Portal hypertension is defined as an increase in hepatic sinusoidal pressure to 6 mm Hg or higher. Cirrhosis is the most common cause of portal hypertension in the western world and results from increased resistance to blood flow at the hepatic sinusoidal level.
Nelson Nathan C - - 2010
Determination of central venous pressure (CVP) is relevant to patients with right heart disease, hypovolemia, and following intravenous fluid therapy. We hypothesized that changes in CVP in dogs could be predicted by measurements of hepatic vein diameter, caudal vena cava (CVC) diameter, and hepatic venous flow velocities. Nine healthy American ...
Massicotte Luc - - 2010
BACKGROUND: A regimen of fluid restriction, phlebotomy, vasopressors, and strict, protocol-guided product replacement has been associated with low blood product use during orthotopic liver transplantation. However, the physiologic basis of this strategy remains unclear. We hypothesized that a reduction of intravascular volume by phlebotomy would cause a decrease in portal ...
Melgosa Maria Teresa - - 2010
Portopulmonary hypertension (PoPH) is a serious condition without an established treatment. Drugs used to treat pulmonary hypertension may have detrimental effects on portal hypertension. This study was designed to assess in patients with PoPH the acute effects of inhaled iloprost (iILO) on pulmonary and hepatic hemodynamics and to evaluate the ...
Huang Hai - - 2010
The aim of this study is to give a hands-on description of the successful monitoring procedure established for extended liver resections and liver transplantations in rats and to provide the typical range of data as obtained before and after a hepatobiliary surgical procedure (right median hepatic vein [RMHV] ligation) in ...
Yoshida Makoto - - 2010
BACKGROUND: Intra-abdominal high pressure and acidosis by carbon dioxide (CO(2)) pneumoperitoneum is known to affect various organ functions. In this study, changes in liver functions and liver histology were investigated during CO(2) pneumoperitoneum in a large animal model. METHODS: Fourteen white pigs were anesthetized with intubation and controlled ventilation. The ...
Kredel M - - 2010
BACKGROUND: Ventilation with high positive end-expiratory pressure (PEEP) can lead to liver dysfunction. We hypothesized that an open lung concept (OLC) using high PEEP impairs liver function and integrity dependent on the stabilization of cardiac output. METHODS: Juvenile female Pietrain pigs instrumented with flow probes around the common hepatic artery ...
Wu Han-Jun - - 2010
Hepatic fibrosis is associated with elevated sinusoidal pressure, which can be transmitted to the hepatic stellate cells (HSCs) in the perisinusoidal space of Disse. Here, we sought to determine the effects of pressure on cellular growth and Src-dependent signaling pathways in the rat HSCs. Cultured rat HSCs were exposed to ...
Millonig Gunda - - 2010
Liver stiffness (LS) as measured by transient elastography [Fibroscan] offers a novel non-invasive approach to assess liver cirrhosis. Since Fibroscan seems to be unreliable in patients with congestive heart failure, it remains to be determined whether hemodynamic changes affect LS irrespective of fibrosis. Using landrace pigs, we studied the direct ...
Giordano Chris - - 2010
BACKGROUND: The common practice of maintaining central venous pressure (CVP) below 5 mm Hg to reduce blood loss during hepatic resection increases the risk of venous air embolism (VAE). We initiated this study after observing that the anteroposterior (AP) diameter of the liver can be much larger than 7 cm, ...
Saner Fuat H - - 2010
Rescue organ offers may help to overcome the organ shortage. However, because of initial poor liver function, the recipient may develop a severe lung injury with the requirement for higher positive end-expiratory pressure (PEEP) levels to achieve adequate oxygenation. Positive end-expiratory pressure has been associated with perfusion impairment in the ...
Seki Mamiko - - 2009
Twelve healthy Beagles were divided into 3 groups of 4 dogs each. To compare 2 methods of total hepatic vascular exclusion (THVE), we investigated the hemodynamic changes during THVE and assessed the influences on hepatic, renal and pancreatic biochemistry and the complications after THVE. In Group A, the thoracic aorta, ...
Takano Hiromichi - - 2009
OBJECTIVE: Hepatic venoconstriction plays a significant role in anaphylactic hypotension in anesthetized rats. The purpose of this study is to determine whether the primary site of anaphylactic venoconstriction in the liver venous circulation occurs prior to or distal to the sinusoidal capillaries. We also determined whether the hepatic blood volume ...
Gouvêa G - - 2009
BACKGROUND: The pulse pressure variation (PPV) index has been shown to be a reliable predictor of fluid responsiveness (FR) in a variety of clinical settings. However, it has not been formally evaluated in the setting of orthotopic liver transplantation (OLT). METHODS: Fifteen (n=15) patients undergoing OLT were enrolled in this ...
Bellazzini Marc A - - 2009
OBJECTIVES: The aim of this study is to determine which maneuvers result in greatest cross-sectional area (CSA) of the internal jugular vein (IJV) and reduce collapsibility as measured by ultrasound during simulated venipuncture. METHODS: A total of 52 healthy adult volunteers were prospectively studied in an academic emergency department. Cross-sectional ...
Peng Tien T Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, - - 2009
We previously showed that a single nucleotide polymorphism in S100A4 was associated with portopulmonary hypertension (PPHTN) in patients with advanced liver disease. We aimed to determine the association between plasma levels of S100A4 and PPHTN. We performed a case-control study of patients with advanced liver disease. Cases with PPHTN had ...
Calvaruso Vincenza - - 2009
Histopathological scoring of disease stage uses descriptive categories without measuring the amount of fibrosis. Collagen, the major component of fibrous tissue, can be quantified by computer-assisted digital image analysis (DIA) using histological sections. We determined relationships between DIA, Ishak stage, and hepatic venous pressure gradient (HVPG) reflecting severity of fibrosis. ...
Zekanovic Drazen - - 2010
OBJECTIVE: The progression of liver cirrhosis eventually increases cardiac output, while blood pressure and systemic vascular resistance are reduced. A complex behavior of portal hemodynamic to hepatic artery and system circulation has not yet been presented. There is a lack in knowledge about the correlation of local and systemic circulation ...
Gulzar Ghulam Mohamad - - 2009
An elevated hepatic venous pressure gradient (HVPG) has been associated with risk of variceal bleeding, and outcome and survival after variceal bleeding. In this pilot study, we measured HVPG in 40 patients with liver cirrhosis and studied its relationship with etiology of liver disease, esophageal variceal size, history of variceal ...
Barakat Fuad - - 2009
PURPOSE: To clarify the occurrence of periportal edema in polytraumatic patients. MATERIALS AND METHODS: Retrospective analysis of computed tomography (CT) scans from 74 polytraumatic patients (12 females, 62 males; 14-88 years old, median 32 years) performed shortly after the trauma. Periportal oedema was found in 22 patients. The existence and ...
Dashwood Michael R - - 2009
The saphenous vein is the most commonly used conduit in patients undergoing coronary artery bypass surgery. However, a high proportion of vein grafts occlude within the first year and over 50% patients require further grafting within 10 years. Using conventional harvesting techniques the saphenous vein is damaged due to considerable ...
Pestel G - - 2009
BACKGROUND: Difference in pulse pressure (dPP) confirms adequate intravascular filling as a prerequisite for tissue perfusion. We hypothesized that both oxygen and dobutamine increase liver tissue oxygen tension (ptO(2)). METHODS: Eight anesthetized pigs received dPP-guided fluid management. Hepatic pO(2) was measured with Clark-type electrodes placed subcapsularly, and on the liver ...
Khan Raza - - 2009
A 50-year-old male with anuria, creatinine of 5.5 and potassium of 6.5 was referred to our hospital for hemodialysis. Before hemodialysis could be initiated, his blood pressure dropped and liver function tests were found to be increasing rapidly. This prompted us to look for cardiac causes of liver ischemia. An ...
Triantos C K - - 2008
BACKGROUND: Hepatic venous pressure gradient (HVPG) measurement is not a routinely used technique, despite its therapeutic and prognostic value. AIM: To review the role of HVPG from published literature. METHODS: Systematic literature review. RESULTS: In acute variceal bleeding, HVPG is prognostic identifying 'difficult to treat' group, which now has defined ...
Biais M - - 2008
BACKGROUND: Stroke volume variation (SVV) is able to predict adequately the individual response to fluid loading. Our objective was to assess whether the SVV measured by a new algorithm (Vigileo; Flotrac) can predict fluid responsiveness. METHODS: Forty mechanically ventilated patients undergoing liver transplantation, who needed volume expansion (VE), were included. ...
Zaky Ahmed - - 2008
We tested the hypothesis that hepatosplanchnic and systemic hemodynamics are improved with equi-effective doses of dopamine (DA) versus norepinephrine (NE) in a brain-dead swine model. Pigs (n = 18) were anesthetized and ventilated. Brain death was induced by epidural balloon inflation, hypoventilation, and hypoxia. After 30 minutes, mechanical ventilation was ...
Lee Kuei-Chuan KC Division of Gastroenterology, Department of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, - - 2008
In liver cirrhosis, the increased production of nitric oxide (NO) contributes to increased systemic and splanchnic vasodilatation. The inhibition of phosphodiesterase-5 (PDE-5), an enzyme responsible for the degradation of cyclic guanosine monophosphate (cGMP), is widely used in the treatment of erectile dysfunction. The aim of our study is to evaluate ...
Ripoll Cristina - - 2008
BACKGROUND: The aim was to investigate the cardiac response during liver transplantation (LT) and analyze its relationship with clinical factors, echocardiographic, and hemodynamic findings. METHODS: All patients undergoing LT for cirrhosis from 1998 to 2004 were included. Clinical data, comprehensive echocardiography, hepatic, and right heart hemodynamic measurements were analyzed. During ...
Saner Fuat H - - 2008
Living-donated liver transplant (LDLT) patients may develop lung edema during reperfusion, requiring higher positive end-expiratory pressure (PEEP) levels, which may impair liver outflow. The aim of the study was to assess the effect of increased PEEP levels on venous liver outflow and systemic hemodynamics in patients after LDLT. Thirty-nine LDLT ...
Hinghofer-Szalkay Helmut G - - 2008
We tested whether hepatic blood flow is altered following central hypovolemia caused by simulated orthostatic stress. After 30 min of supine rest, hemodynamic, plasma density, and indocyanine green (ICG) clearance responses were determined during and after release of a 15-min 40 mmHg lower body negative pressure (LBNP) stimulus. Plasma density ...
Doursout Marie-Francoise - - 2008
Sepsis is a major cause of morbidity and mortality. NO, an endogenous vasodilator, has been associated with the hypotension, catecholamine hyporesponsiveness, and myocardial depression of septic shock. Although iNOS is thought to be responsible for the hypotension and loss of vascular tone occurring several hours after endotoxin administration, little is ...
Zipprich Alexander - - 2008
In cirrhosis, hepatic venous pressure gradient is used to measure portal venous and sinusoidal pressures, as well as drug-induced decreases of elevated pressures. The aim of this study was to investigate the influence of hepatic arterial flow (HAF) changes on portal venous perfusion (PVPP) and wedged hepatic venous pressure (WHVP). ...
Feltracco P - - 2008
Parenteral analgesics are still diffusely administered for postoperative pain after major liver resection, while epidural analgesia is widely criticized because of possible changes in the postoperative coagulation profile. The safety of regional anesthesia in liver resections is based on appropriate timing of needle placement and catheter removal and on the ...
Okada Yoshikiyo - - 2008
Ethanol may cause an increase in sinusoidal pressure accompanied by portal hypertension. Hepatic stellate cells (HSCs) located in hepatic sinusoids may therefore be frequently exposed to dual stimulations of mechanical pressure and ethanol exposure in alcoholic liver injury. In this study, the effects of pressure loading and ethanol exposure on ...
Sawyer Greta J - - 2008
BACKGROUND: Clinical application of hydrodynamic gene delivery to the liver requires the use of small volumes, an evaluation of the cardiovascular consequences of acute volume overload, and a better understanding of the intrahepatic vascular pressures driving gene delivery. Injection of DNA solution into the isolated segment of inferior vena cava ...
Youssef Youssef Farouk - - 2008
Intra-abdominal sepsis was induced by open cecal ligation and puncture (OCLP) technique. Sixty rats were randomly divided into three equal groups each of 20. G1 was used as a control. G2 were subjected to laparotomy and closure after 12 hours from (OCLP) via the same incision. In G3, pneumoperitoneum was ...
De Binay-K - - 2008
AIM: To study the hemodynamic effects of spironolactone with propranolol vs propranolol alone in the secondary prophylaxis of variceal bleeding. METHODS: Thirty-five cirrhotics with variceal bleeding randomly received propranolol (n = 17: Group A) or spironolactone plus propranolol (n = 18: Group B). Hemodynamic assessment was performed at baseline and ...
Uchiyama Kazuhisa - - 2009
BACKGROUND AND AIMS: Bleeding from the hepatic vein is closely related to central venous pressure (CVP). To evaluate the effect of low central venous pressure during a hepatectomy, the infrahepatic inferior vena cava (IVC) was half clamped. PATIENTS AND METHODS: Between 2006 and 2007, 20 patients undergoing major hepatectomy with ...
Torres Orlando Jorge Martins - - 2008
PURPOSE: To describe the hemodynamic alterations during orthotopic liver transplantation in pigs. METHODS: In the period from April 2004 to December 2005, forty-four female Landrace pigs, weighting between 32 and 38 Kg underwent orthotopic liver transplantation. The animals were divided into two groups, donor and recipient pairs, which received whole ...
Kumar Ashish - - 2008
Portal hypertension is a clinical syndrome defined by a pathological increase in portal pressure. The development of cirrhosis of the liver is characterized by clinical manifestations related to portal hypertension like esophageal varices, ascites, bleeding, and encephalopathy. Direct measurement of portal pressure is invasive, inconvenient, and clinically impractical. Currently, the ...
Kumar M - - 2008
BACKGROUND: Determining a relationship between specific histological parameters in cirrhosis and hepatic venous pressure gradient can be used to subclassify cirrhosis. AIM: To determine the relationship between hepatic venous pressure gradient and specific histological parameters in cirrhosis. METHODS: Forty-seven patients (mean age: 46.2 +/- 13.6 years; 36 male) with biopsy-proven ...
Wolf Anne T - - 2008
BACKGROUND: Liver biopsy is the gold standard for establishing cirrhosis, but may provide inadequate tissue for interpretation in some patients. GOALS: The aim of this study was to determine whether the hepatic venous pressure gradient predicts the presence of cirrhosis. STUDY: Patients with liver disease who had undergone hepatic venous ...
Shibamoto Toshishige - - 2008
The localization of increased intrahepatic vascular resistance and the segmental vascular responsiveness to endothelin-1 are not well known in liver cirrhosis. We determined the segmental vascular resistances and their response to endothelin-1 of isolated portally perfused bile duct ligation (BDL)-induced cirrhotic rat livers. The portal occlusion pressure (Ppo) and the ...
Prado Cibele M - - 2008
PURPOSE: This study sought to evaluate the efficiency of glycol methacrylate-embedding medium to detect morphological alterations of human saphenous vein submitted to brief and crescent pressurizations. METHODS: Saphenous veins of 20 CABG patients were randomly distributed into four experimental groups (control, 100, 200 and 300 mmHg pressures during 15 seconds). ...
Yoshida Hiroshi - - 2008
We describe an effective technique for the low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb after major hepatectomy with pancreatoduodenectomy (PD). After hepatectomy and PD, reconstruction is performed by a modification of Child's method. A pancreaticojejunostomy is completed with interrupted sutures between the ...
Hashiguchi Tetsuaki - - 2008
PURPOSE: Using a lipopolysaccharide (LPS)-treated porcine model, we examined: (1) whether nitric oxide (NO), anandamide, and tetrahydrobiopterin (BH4) increased or not in early endotoxic shock; and (2) the location of the major site of production of these molecules, by comparing their concentrations in arteries and the portal and hepatic veins. ...
Regueira Tomas - - 2008
INTRODUCTION: Low blood pressure, inadequate tissue oxygen delivery and mitochondrial dysfunction have all been implicated in the development of sepsis-induced organ failure. This study evaluated the effect on liver mitochondrial function of using norepinephrine to increase blood pressure in experimental sepsis. METHODS: Thirteen anaesthetized pigs received endotoxin (Escherichia coli lipopolysaccharide ...
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