Document Detail


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.
MedLine Citation:
PMID:  21238884     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Ulrich Thalheimer; Lia Bellis; Claudio Puoti; Andrew K Burroughs
Related Documents :
17562174 - Spontaneous and bolus-induced motility in the chronically obstructed guinea-pig small i...
7053654 - Interaction of lower esophageal sphincter pressure and length of sphincter in the abdom...
7338814 - Oesophageal and diaphragmatic activity during sucking in lambs.
15612244 - Study of visceral hypersensitivity in irritable bowel syndrome.
8296824 - Increased vulnerability to neuronal damage after umbilical cord occlusion in fetal shee...
2772104 - Cardiovascular reactivity, emotional factors, and home blood pressures in black males w...
Publication Detail:
Type:  Journal Article     Date:  2010-12-31
Journal Detail:
Title:  European journal of internal medicine     Volume:  22     ISSN:  1879-0828     ISO Abbreviation:  Eur. J. Intern. Med.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9003220     Medline TA:  Eur J Intern Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  5-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Affiliation:
The Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Should we routinely measure portal pressure in patients with cirrhosis, using hepatic venous pressur...
Next Document:  The oral glucose tolerance test (OGTT) revisited.