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Splanchnic perfusion

B M Belik
AIM: To substantiate pathogenetic expediency and to evaluate the clinical efficacy of the drug use serotonin adipate (dinaton) in a complex correction enteral insufficiency syndrome (EIN) in patients with generalized peritonitis (GP). MATERIAL AND METHODS: The comparative analysis of results of treatment of 182 patients with GP, which in principle approach to EIN correction in the postoperative period were divided into two groups. Group I consisted of 92 patients who received standard intensive therapy using conventional methods of stimulation of intestinal peristalsis...
2016: Khirurgiia
Daniela Verzola, Francesca Ansaldo, Samantha Milanesi, Emanuele Luigi Parodi, Gian Marco Rosa, Antonella Sofia, Alice Bonanni, Francesca Viazzi, Manrico Balbi, Giacomo Garibotto
Fibroblast Growth Factor-23 (FGF-23) accumulates in blood of patients with chronic kidney disease (CKD) and is associated both with cardiovascular complications and disease progression. However, our knowledge of the sites and mechanisms which regulate plasma FGF-23 is still incomplete. We measured plasma intact FGF-23 across the kidney, splanchnic organs and lung in eleven patients (eGFR 60 ± 6 ml/min) during elective diagnostic cardiac catheterizations. In these patients FGF-23 was removed by the kidney, with a fractional extraction (FE) of ~22%...
August 24, 2016: American Journal of Physiology. Renal Physiology
Naaventhan Palaniyappan, Eleanor Cox, Christopher Bradley, Robert Scott, Andrew Austin, Richard O'Neill, Greg Ramjas, Simon Travis, Hilary White, Rajeev Singh, Peter Thurley, Indra Neil Guha, Susan Francis, Guruprasad Padur Aithal
BACKGROUND & AIMS: Hepatic venous pressure gradient (HVPG) measurement is currently the only validated technique to accurately evaluate changes in portal pressure. In this study, we evaluate the use of non-contrast quantitative magnetic resonance imaging (MRI) as a surrogate measure of portal pressure. METHODS: 30 patients undergoing HVPG measurement were prospectively recruited. MR parameters of longitudinal relaxation time (T1), perfusion of the liver and spleen (by arterial spin labelling), and blood flow in the portal, splanchnic and collateral circulation (by phase-contrast MRI) were assessed...
July 27, 2016: Journal of Hepatology
Valentina Bozzetti, Giuseppe Paterlini, Paola De Lorenzo, Diego Gazzolo, Maria Grazia Valsecchi, Paolo E Tagliabue
OBJECTIVE: To detect changes in splanchnic perfusion and oxygenation induced by 2 different feeding regimens in infants with intrauterine growth restriction (IUGR) and those without IUGR. STUDY DESIGN: This was a randomized trial in 40 very low birth weight infants. When an enteral intake of 100 mL/kg/day was achieved, patients with IUGR and those without IUGR were randomized into 2 groups. Group A (n = 20) received a feed by bolus (in 10 minutes), then, after at least 3 hours, received the same amount of formula by continuous nutrition over 3 hours...
September 2016: Journal of Pediatrics
Marco Di Pascoli, Francesca Zampieri, Alberto Verardo, Paola Pesce, Cristian Turato, Paolo Angeli, David Sacerdoti, Massimo Bolognesi
UNLABELLED: In cirrhosis, 11,12-epoxyeicosatrienoic acid (EET) induces mesenteric arterial vasodilation, which contributes to the onset of portal hypertension. We evaluated the hemodynamic effects of in vivo inhibition of EET production in experimental cirrhosis. Sixteen control rats and 16 rats with carbon tetrachloride-induced cirrhosis were studied. Eight controls and eight rats with cirrhosis were treated with the specific epoxygenase inhibitor N-(methylsulfonyl)-2-(2-propynyloxy)-benzenehexanamide (MS-PPOH; 20 mg/kg/day) for 3 consecutive days...
September 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Lina Carlbom, Daniel Espes, Mark Lubberink, Olof Eriksson, Lars Johansson, Leif Jansson, Olle Korsgren, Håkan Ahlström, Per-Ola Carlsson
AIMS/HYPOTHESIS: The aim of this study was to investigate pancreatic perfusion and its response to a glucose load in patients with type 1 diabetes mellitus compared with non-diabetic ('healthy') individuals. METHODS: Eight individuals with longstanding type 1 diabetes and ten sex-, age- and BMI-matched healthy controls underwent dynamic positron emission tomography scanning with (15)O-labelled water before and after intravenous administration of glucose. Perfusion in the pancreas was measured...
September 2016: Diabetologia
Mario Meola, Federico Nalesso, Ilaria Petrucci, Sara Samoni, Claudio Ronco
Renal failure commonly occurs in patients affected by cirrhosis, especially when there is ascites. It is typically secondary to intercurrent events that can further compromise blood flow in conditions of relatively decreased renal perfusion. Hepatorenal syndrome (HRS) is a particular and common type of kidney failure that affects patients with liver cirrhosis or, less frequently, with fulminant hepatic failure. The syndrome is characterized by splanchnic vasodilation and renal vasoconstriction. The classification of HRS identifies 2 categories of kidney failure, known as type 1 and type 2 HRS, that occur in patients with either cirrhosis or fulminant hepatic failure...
2016: Contributions to Nephrology
Olivier Windisch, Claudia-Paula Heidegger, Raphaël Giraud, Philippe Morel, Léo Bühler
This review article analyzes, through a nonsystematic approach, the pathophysiology of acute pancreatitis (AP) with a focus on the effects of thoracic epidural analgesia (TEA) on the disease. The benefit-risk balance is also discussed. AP has an overall mortality of 1 %, increasing to 30 % in its severe form. The systemic inflammation induces a strong activation of the sympathetic system, with a decrease in the blood flow supply to the gastrointestinal system that can lead to the development of pancreatic necrosis...
2016: Critical Care: the Official Journal of the Critical Care Forum
Anne E Richter, Trijntje E Schat, Koenraad N J A Van Braeckel, Sicco A Scherjon, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Drugs with antihypertensive action are frequently used in obstetrics for the treatment of preeclampsia (labetalol) and tocolysis (nifedipine) or for neuroprotection (MgSO4), and may affect the hemodynamics of preterm born neonates. OBJECTIVE: The aim of this study was to assess whether maternal antihypertensive drugs affect multisite oxygenation levels of the neonate. METHODS: Eighty preterm neonates of ≤32 weeks of gestational age were monitored using near-infrared spectroscopy...
2016: Neonatology
Trijntje E Schat, Fardou H Heida, Maarten Schurink, Michelle E van der Laan, Christian V Hulzebos, Arend F Bos, Elisabeth M W Kooi, Jan B F Hulscher
OBJECTIVES: The underlying pathophysiology of necrotising enterocolitis (NEC) remains incompletely understood, particularly the role of intestinal perfusion. We aimed to determine the relation between cerebral and splanchnic fractional tissue oxygen extraction (FTOE), a marker for tissue underperfusion, with intestinal fatty acid-binding protein in plasma (I-FABPp), a marker for intestinal damage, in infants with NEC. Furthermore, we investigated the combined courses of cerebral and splanchnic FTOE values and I-FABPp levels in uncomplicated (conservative treatment) and complicated NEC (surgery or death)...
April 5, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Kohei Eguchi, Hideaki Kashima, Akiko Yokota, Kohei Miura, Masako Yamaoka Endo, Harutoyo Hirano, Toshio Tsuji, Yoshiyuki Fukuba
Little is known about the effect of sweet taste stimulus on gastrointestinal motility and splanchnic blood flow. We examined whether gastric myoelectrical activity and/or celiac artery blood flow (CABF), which perfuses the stomach, are increased following an oral sensation of sweetness. After overnight fasting, 11 subjects rested for 5min and sipped, but not swallowed, one of four solutions for 1min. The fluid was then spat out, and subjects remained at rest for a further 10min. Fluids were approximately 15ml of three glucose solutions (4, 16, or 48%) or distilled water...
May 2016: Autonomic Neuroscience: Basic & Clinical
Erika M Boerman, Jesse E Everhart, Steven S Segal
Aging is associated with vascular dysfunction that impairs tissue perfusion, physical activity, and the quality of life. Calcium signaling in endothelial cells (ECs) is integral to vasomotor control, exemplified by localized Ca(2+) signals within EC projections through holes in the internal elastic lamina (IEL). Within these microdomains, endothelium-derived hyperpolarization is integral to smooth muscle cell (SMC) relaxation via coupling through myoendothelial gap junctions. However, the effects of aging on local EC Ca(2+) signals (and thereby signaling between ECs and SMCs) remain unclear, and these events have not been investigated in vivo...
May 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
V Mezger, F Balzer, M Habicher, M Sander
Venous saturation is an important parameter to assess the ratio between oxygen delivery and oxygen consumption for both intensive care medicine and during perioperative care. Mixed venous saturation (SvO2) is the most reliable parameter in this setting. Due to the high invasiveness of measuring mixed venous saturation, the less invasive central venous saturation (ScvO2) has been entrenched for determining the balance of oxygen delivery and consumption. However, central venous saturation is inferior compared to mixed venous saturation as it does not cover the lower part of the body, including splanchnic perfusion...
March 1, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Tzu-Hao Li, Chia-Chang Huang, Ying-Ying Yang, Kuei-Chuan Lee, Shie-Liang Hsieh, Yun-Cheng Hsieh, Lin Alan, Han-Chieh Lin, Shou-Dong Lee, Chang-Youh Tsai
BACKGROUND AND AIMS: By blocking TNFα-related effects, thalidomide not only inhibits hepatic fibrogenesis but improves peripheral vasodilatation and portal hypertension in cirrhotic rats. Nonetheless, the investigation of thalidomide's effects on splanchnic and collateral microcirculation has been limited. Our study explored the roles of intestinal and mesenteric TNFα along with inflammasome-related pathway in relation to cirrhosis and the splanchnic/collateral microcirculation. METHODS: Using in vivo and in vitro approaches, mechanisms of the effects of thalidomide on intestinal and mesenteric inflammatory, vasodilatory and angiogenic cascades-related abnormalities were explored in cirrhotic rats that had received 1-month thalidomide (C-T) treatment...
2016: PloS One
Ahmed Mukhtar, Hany Dabbous
Splanchnic circulation is the primary mechanism that regulates volumes of circulating blood and systemic blood pressure in patients with cirrhosis accompanied by portal hypertension. Recently, interest has been expressed in modulating splanchnic circulation in patients with liver cirrhosis, because this capability might produce beneficial effects in cirrhotic patients undergoing a liver transplant. Pharmacologic modulation of splanchnic circulation by use of vasoconstrictors might minimize venous congestion, replenish central blood flow, and thus optimize management of blood volume during a liver transplant operation...
January 28, 2016: World Journal of Gastroenterology: WJG
Werner Ribitsch, Daniel Schneditz, Casper F M Franssen, Gernot Schilcher, Vanessa Stadlbauer, Jörg H Horina, Alexander R Rosenkranz
BACKGROUND AND OBJECTIVES: Ultrafiltration (UF) of excess fluid activates numerous compensatory mechanisms during hemodialysis (HD). The increase of both total peripheral and splanchnic vascular resistance is considered essential in maintaining hemodynamic stability. The aim of this study was to evaluate the extent of UF-induced changes in hepato-splanchnic blood flow and resistance in a group of maintenance HD patients during regular dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Hepato-splanchnic flow resistance index (RI) and hepato-splanchnic perfusion index (QI) were measured in 12 chronic HD patients using a modified, non-invasive Indocyaningreen (ICG) dilution method...
2015: PloS One
Chun-Yu Wu, Kuang-Cheng Chan, Ya-Jung Cheng, Yu-Chang Yeh, Chiang-Ting Chien
INTRODUCTION: Fluid resuscitation is an indispensable procedure in the acute management of hemorrhagic shock for restoring tissue perfusion, particularly microcirculation in splanchnic organs. Resuscitation fluids include crystalloids, hypertonic saline (HTS), and synthetic colloids, and their selection affects the recovery of microcirculatory blood flow and reactive oxygen species (ROS) formation, which is often evident in the kidney, following reperfusion. In this study, the effects of acute resuscitation with 0...
2015: Critical Care: the Official Journal of the Critical Care Forum
Ryotaro Kato, Michael R Pinsky
This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chronic hypertension, targeting a higher MAP of 80-85 mmHg minimizes renal injury, but it comes with increased risk of arrhythmias. Importantly, MAP alone should not be used as a surrogate of organ perfusion pressure, especially under conditions in which intracranial, intra-abdominal or tissue pressures may be elevated...
December 2015: Annals of Intensive Care
Wei Qiao, Jing Li, Ying Li, Duan Qian, Lei Chen, Xiansen Wei, Jiangli Jin, Yong Wang
OBJECTIVES: Postprandial hypotension (PPH) is a unique clinical phenomenon in the elderly, but its underlying pathogenesis has not been completely elucidated, and drug treatment is still in clinical exploratory stage. The aim of the study was to evaluate the relationship between the fall in postprandial blood pressure and splanchnic blood flow, and to provide a theoretical basis for the treatment of PPH by taking acarbose. PATIENTS AND METHODS: The study included 20 elderly inpatients diagnosed with PPH concomitant with abnormal glucose metabolism at stable condition...
February 2016: Blood Pressure Monitoring
Khushica Purbhoo, Mboyo Di Tamba Willy Vangu
BACKGROUND: When using (99m)Tc sestamibi for myocardial perfusion imaging, increased splanchnic activity creates a problem in the visual and quantitative interpretation of the inferior and infero-septal walls of the left ventricle. We sought to determine whether the administration of diluted lemon juice or full-fat milk would be effective in reducing interfering infra-cardiac activity and therefore result in an improvement in image quality. We compared the administration of full-fat milk and diluted lemon juice to a control group that had no intervention...
July 2015: Cardiovascular Journal of Africa
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