Document Detail


Intestinal decontamination improves liver haemodynamics in patients with alcohol-related decompensated cirrhosis.
MedLine Citation:
PMID:  19210289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Endotoxaemia is commonly seen in cirrhotic patients with ascites and this may be associated with increased portal pressure. AIM: To investigate the effect of intestinal decontamination on liver haemodynamics in alcohol-related cirrhotic patients with ascites. METHODS: We included 30 patients. At day 0, systemic and splanchnic circulation endotoxin levels were determined and HVPG measurement performed. Patients received rifaximin (1200 mg/day) for 28 days. At day 29, systemic and splanchnic circulation endotoxin levels were determined and HVPG measurement performed again. RESULTS: Median (range) plasma endotoxin levels decreased significantly after rifaximin administration both in systemic [1.45(0-3.1) vs. 0.7(0-2.7), P < 0.0001] and splanchnic circulation [1.8(0-3.4) vs. 0.8(0-2.1), P < 0.0001]. Meanwhile, the difference seen in endotoxin levels between the splanchnic and systemic circulation at day 0 (P = 0.001) was not noted at day 29 (P = 0.137). HVPG measurement was possible in 28 patients. Median (range) HVPG values were 18 mmHg (12.7-26.3) on day 0 vs. 14.7 mmHg (7-20) on day 29 (P < 0.0001). HVPG decreased after rifaximin in 23, remained stable in two and increased in three patients. CONCLUSION: Hepatic venous pressure gradient values decreased significantly after intestinal decontamination with rifaximin in patients with alcohol-related decompensated cirrhosis and this might have been achieved through significant reduction of plasma endotoxin levels.
Authors:
J Vlachogiannakos; A S Saveriadis; N Viazis; I Theodoropoulos; K Foudoulis; S Manolakopoulos; S Raptis; D G Karamanolis
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Publication Detail:
Type:  Journal Article     Date:  2009-02-07
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  29     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  992-9     Citation Subset:  IM    
Affiliation:
2nd Department of Gastroenterology, Evangelismos Hospital, Athens, Greece. jvlachog@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Alcohol-Related Disorders
Anti-Infective Agents / therapeutic use*
Ascites / drug therapy
Endotoxins / metabolism*
Female
Humans
Liver Circulation / drug effects*
Liver Cirrhosis / blood*
Male
Middle Aged
Rifamycins / administration & dosage*
Treatment Outcome
Venous Pressure / drug effects*
Chemical
Reg. No./Substance:
0/Anti-Infective Agents; 0/Endotoxins; 0/Rifamycins; 88747-56-2/rifaximin
Comments/Corrections
Comment In:
Aliment Pharmacol Ther. 2009 Aug;30(3):309-11; author reply 311-2   [PMID:  19624465 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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