| Vasopressin analogues in the treatment of hepatorenal syndrome and gastrointestinal haemorrhage. | |
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MedLine Citation:
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PMID: 18683479 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Bleeding of oesophageal varices and hepatorenal syndrome are most dramatic complications in gastroenterology. They develop in consequence of progressively increasing blood flow entering the vasodilated splanchnic bed and the portal vein where blood flow meets intrahepatic resistance. Porto-systemic collateral veins are formed to bypass the cirrhotic liver. Intravascular pressure is very high in these collaterals, causing the venous walls to expand into esophageal varices, which eventually may rupture and bleed. This splanchnic blood pooling generates hypovolemia in the central and arterial system, initiating activation of the renin-angiotensin-aldosteron and sympathetic nervous system. These compensatory mechanisms induce renal vasoconstriction, followed by hypoperfusion of the kidneys and development of hepatorenal syndrome. Vasoconstrictors like terlipressin inhibit splanchnic blood flow, thus reducing portal and variceal pressure, which is followed by termination ofvariceal bleeding, by normalization of central and arterial blood volume and by an improvement of kidney function and hepatorenal syndrome. |
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Authors:
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Klaus D Döhler; Markus Meyer |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Best practice & research. Clinical anaesthesiology Volume: 22 ISSN: 1521-6896 ISO Abbreviation: Best Pract Res Clin Anaesthesiol Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-08-07 Completed Date: 2008-10-17 Revised Date: 2011-04-28 |
Medline Journal Info:
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Nlm Unique ID: 101121446 Medline TA: Best Pract Res Clin Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 335-50 Citation Subset: IM |
Affiliation:
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Curatis Pharma GmbH, Karl-Wiechert-Allee 76, D-30625 Hannover, Germany. doehler@curatis-pharma.de |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Circulation / physiology Gastrointestinal Hemorrhage / drug therapy*, physiopathology Hepatorenal Syndrome / drug therapy*, physiopathology Humans Hypovolemia / drug therapy, physiopathology Liver Cirrhosis / physiopathology Lypressin / analogs & derivatives, therapeutic use Splanchnic Circulation / drug effects, physiology Vasoconstrictor Agents / therapeutic use* Vasopressins / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasoconstrictor Agents; 11000-17-2/Vasopressins; 14636-12-5/terlipressin; 50-57-7/Lypressin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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