Document Detail


Portal hypertension and blood viscosity.
MedLine Citation:
PMID:  17975475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies, exploring the effect of blood viscosity on portal pressure in portal hypertensive humans and animal models, have shown conflicting results. In a series of studies, in portal vein constricted rats, we investigated effects of reduced blood viscosity on the hyperdynamic circulation, portal pressure, and vascular geometry. Blood was withdrawn at a rate of 0.3 mL/min for 15 minutes followed by 15 minutes of stabilization. The shed blood or Haemaccel was infused at the same rate and volume as used for withdrawal. Hemodynamic measurements were performed using radioactive microspheres. Blood viscosity was measured with an Ostwald viscometer. Vascular hindrance (reflecting vessel geometry) was calculated as resistance/viscosity ratio. In normal and portal hypertensive rats, acute volume replacement with Haemaccel, induced increase in systemic and splanchnic blood flows reflecting mainly changes in viscosity and not in blood vessel geometry. However, 24 hours later, in Haemaccel treated animals, an increased splanchnic arteriolar and porto-collateral vascular hindrance were observed. This indicated vasoconstriction in the porto-collateral vascular bed. The increase in portal venous inflow after acute volume restitution with Haemaccel was prevented by pretreatment with propranolol. Although, caution should be taken in extrapolating these results to humans, we would like to speculate that during a portal hypertensive-related bleeding episode: (1) volume replacement with low viscosity plasma expanders may aggravate the hyperdynamic circulation of portal hypertension. (2) Slow rate volume replacement enables hemodynamic adaptation to occur. (3) Volume replacement maybe more safe in a subject pretreated with propranolol.
Authors:
Emanuel Sikuler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  41 Suppl 3     ISSN:  0192-0790     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-11-02     Completed Date:  2008-02-06     Revised Date:  2008-07-10    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S262-5     Citation Subset:  IM    
Affiliation:
Department of Medicine B', Faculty of Health Sciences, The Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel. sikuler@bgu.ac.il
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / pharmacology
Animals
Blood Viscosity*
Collateral Circulation / drug effects
Disease Models, Animal
Esophageal and Gastric Varices / blood,  complications*,  etiology,  physiopathology
Gastrointestinal Hemorrhage / blood,  drug therapy,  etiology*,  physiopathology
Humans
Hypertension, Portal / blood*,  complications,  physiopathology
Plasma Substitutes / adverse effects,  pharmacology*
Polygeline / adverse effects,  pharmacology*
Portal Pressure / drug effects*
Propranolol / pharmacology
Rats
Splanchnic Circulation / drug effects*
Vascular Resistance / drug effects
Vasoconstriction / drug effects
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Plasma Substitutes; 525-66-6/Propranolol; 9015-56-9/Polygeline

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


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