| Detection of early central circulatory transits in patients with cirrhosis by gamma variate fit of indicator dilution profiles. | |
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MedLine Citation:
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PMID: 15576626 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients with cirrhosis have hyperdynamic circulation with abnormally distributed blood volume and widespread arteriovenous communications. We aimed to detect possible very early (i.e., before 4 s) and early (i.e., after 4 s) central circulatory transits and their potential influence on determination of central and arterial blood volume (CBV). Thirty-six cirrhotic patients and nineteen controls without liver disease undergoing hemodynamic catheterization were given central bolus injections of albumin with different labels. Exponential and gamma variate fits were applied to the indicator dilution curves, and the relations between flow, circulation times, and volumes were established according to kinetic principles. No significant very early central circulatory transits were identified. In contrast, early (i.e., 4 s to maximal) transits corresponding to a mean of 5.1% (vs. 0.8% in controls; P < 0.005) of cardiac output (equivalent to 0.36 vs. 0.05 l/min; P < 0.01) were found in cirrhotic patients. These early transits averaged 7.7 vs. 12.7 and 17.2 s of ordinary central transits of cirrhotic patients and controls, respectively (P < 0.001). Early transits were directly correlated to the alveolar-arterial oxygen difference in the cirrhotic patients (r = 0.46, P < 0.01) but not in controls (r = 0.04; not significant). There was good agreement between the CBV determined by the conventional indicator dilution method and that determined by separation of early and ordinary transits by the gamma variate fit method (1.51 vs. 1.53 liter; not significant). In conclusion, no very early central circulatory transits were identified in cirrhotic patients. A significant part of the cardiac output undergoes an early transit, probably through pulmonary shunts or areas with low ventilation-perfusion ratios in cirrhotic patients. Composite determination of CBV by the gamma variate fit method is in close agreement with established kinetic methods. The study provides further evidence of abnormal central circulation in cirrhosis. |
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Authors:
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Jens H Henriksen; Søren Møller; Stefan Fuglsang; Flemming Bendtsen |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2004-12-02 |
Journal Detail:
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Title: American journal of physiology. Gastrointestinal and liver physiology Volume: 288 ISSN: 0193-1857 ISO Abbreviation: Am. J. Physiol. Gastrointest. Liver Physiol. Publication Date: 2005 Apr |
Date Detail:
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Created Date: 2005-03-14 Completed Date: 2005-04-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100901227 Medline TA: Am J Physiol Gastrointest Liver Physiol Country: United States |
Other Details:
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Languages: eng Pagination: G677-84 Citation Subset: IM |
Affiliation:
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Dept. of Clinical Physiology and Nuclear Medicine, 239, Hvidovre Hospital, DK-2650 Hvidovre, Denmark. jens.h.henriksen@hh.hosp.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Arteries / physiopathology Blood Circulation* Blood Volume Cardiac Output Case-Control Studies Female Gases / blood Hemodynamics Humans Indicator Dilution Techniques Liver Cirrhosis / physiopathology* Male Middle Aged Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Gases |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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