| Should we routinely measure portal pressure in patients with cirrhosis, using hepatic venous pressure gradient (HVPG) as a guide for prophylaxis and therapy of bleeding and rebleeding? No. | |
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MedLine Citation:
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PMID: 21238884 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Portal hypertension (PH) is a severe complication of liver cirrhosis. Measurement of the degree of portal hypertension is usually performed by measuring the hepatic venous pressure gradient (HVPG) which is the difference between the free hepatic venous pressure (FHVP) and the wedged hepatic venous pressure (WHPG). The HVPG accurately reflects the degree of PH in the majority of liver diseases. PH is defined by an increase of HVPG values above the normal upper limit of 5mmHg, while clinically significant PH is defined by an HVPG to≥10mmHg. Although measurement of HVPG potentially has several applications, in clinical practice its major use has been related to the assessment of hemodynamic response to pharmacological therapy, in order to evaluate the efficacy of treatment and to predict the risk of rebleeding from esophageal varices. When properly performed, HVPG is a reliable, safe and good predictive tool in the management of portal hypertension. However, the need for appropriate equipment, sufficient and reliable operators and costs, have discouraged its use outside Liver Units specifically devoted to the clinical management of portal hypertension. This has diminished its applicability. Combining its use with transjugular liver biopsy and using the prognostic value of HVPG may help encourage its use. |
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Authors:
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Ulrich Thalheimer; Lia Bellis; Claudio Puoti; Andrew K Burroughs |
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Publication Detail:
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Type: Journal Article Date: 2010-12-31 |
Journal Detail:
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Title: European journal of internal medicine Volume: 22 ISSN: 1879-0828 ISO Abbreviation: Eur. J. Intern. Med. Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9003220 Medline TA: Eur J Intern Med Country: Netherlands |
Other Details:
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Languages: eng Pagination: 5-7 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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The Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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