Document Detail


Effects of intraperitoneal albumin on systemic and cerebral hemodynamics in a Swine model of acute liver failure.
MedLine Citation:
PMID:  21524179     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
ABSTRACT Background: Currently, albumin dialysis is the most widely used nonbiological liver support system. We hypothesized that direct peritoneal albumin exposure in the peritoneal cavity would stabilize blood flow and prevent liver and brain injury, in the same way that had previously been seen with extracorporeal albumin dialysis systems. Materials and Methods: Fourteen Landrace pigs (weight 25-30 kg) underwent 70% right hepatectomy and were randomly assigned into a control (C, n = 7) and an intraperitoneal albumin treated group (A, n = 7). The systemic, cerebral, and pulmonary hemodynamic parameters of the animals were recorded at 0, 6, 9, and 12 hr following reperfusion of the liver remnant. Results: Mean arterial blood pressure, cardiac output, and stroke volume were significantly higher in group A at the end of the experiment. Significantly higher mean intracranial pressure (ICP) values were observed in group C compared to group A, both at 9 hr (21.3 ± 5.2 versus 14.1 ± 3.5 mmHg, p < .0005) and 12 hr (23 ± 4.3 versus 11 ± 3.5 mmHg, p < .0005). On the contrary, cerebral perfusion pressure (CPP) remained stable in albumin-treated groups after the sixth postreperfusion hour. Mean pulmonary artery pressure and pulmonary vascular resistance (PVR) were significantly lower in group A compared to group C at 12 hr, while pulmonary capillary wedge pressure (PCWP) stabilized in albumin-treated animals. Conclusions: This study provides the first evidence that intraperitoneal albumin may be able to attenuate systemic, pulmonary, and cerebral hemodynamic disturbances associated with acute liver failure.
Authors:
Aliki Tympa; Constantinos Nastos; George Defterevos; Apostolos Papalois; Konstantinos Kalimeris; Georgia Kostopanagiotou; Ioannis Vassiliou; Vassilios Smyrniotis; Nikolaos Arkadopoulos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of investigative surgery : the official journal of the Academy of Surgical Research     Volume:  24     ISSN:  1521-0553     ISO Abbreviation:  J Invest Surg     Publication Date:  2011  
Date Detail:
Created Date:  2011-04-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809255     Medline TA:  J Invest Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  129-33     Citation Subset:  IM    
Affiliation:
1Fourth Department of Surgery, Attikon University Hospital, Athens, Greece.
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