Abnormal tissue oxygenation in patients with cirrhosis and liver failure

Moreau, Richard; Lee, Samuel S.; Soupison, Thierry; Roche-Sicot, J; Sicot, C

doi:10.1016/s0168-8278(88)80512-9

Cited by 111 publications

(58 citation statements)

References 31 publications

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“…In this study, however, although the degree of portal hypertension was related to the severity of cirrhosis, no significant corre lation was found between portal pressure and renal blood flow. Liver failure has been shown to induce decreased systemic vascular resistance [8,9] and peripheral vasodila tion has been suggested to cause a renal hypoperfusion due to a reflex increase in renal vascular tone [3,4,17], In the present study, however, although the degree of peripheral vasodilation was related to the severity of cirrhosis, no signficant correlation was found between systemic vascular resistance and renal blood flow. Moreover, systemic vascu lar resistance (and the other signs of the systemic hyper kinetic syndrome) was not different between patients with ascites and those without ascites.…”

Section: Discussioncontrasting

confidence: 69%

“…On the other hand, liver failure-induced alterations in splanchnic and/or systemic hemodynamics might have contributed to renal hypoperfusion associated with ascites. Liver failure has been shown to increase the degree of portal hypertension [8,9] and it has been suggested that increased portal pressure may elicit a reflex decrease in renal blood flow [3]. In this study, however, although the degree of portal hypertension was related to the severity of cirrhosis, no significant corre lation was found between portal pressure and renal blood flow.…”

Section: Discussioncontrasting

confidence: 62%

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Renal Hemodynamics in Patients with Cirrhosis: Relationship with Ascites and Liver Failure

Moreau

Gaudin

Hadengue

et al. 1993

Nephron

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In patients with cirrhosis and ascites decreased renal blood flow might be related to the severity of liver disease but the relationship beween the severity of cirrhosis and renal perfusion has not yet been established. Thus we measured renal, systemic and splanchnic hemodynamics in 63 patients with ascites and in 28 without ascites. When compared to patients without ascites, patients with ascites had lower renal blood flow (1,170 ± 100 vs. 935 ± 55 ml/min/1.73 m²; mean ± SEM, p < 0.05) and renal perfusion pressure (78 ± 2 vs. 72 ± 1 mm Hg, p < 0.05 and higher inferior vena cava pressure (6.5 ± 0.7 vs. 10.7 ± 0.7 mm Hg, p < 0.05). Patients with ascites had significantly higher serum bilirubin concentrations, hepatic venous pressure gradient and lower serum albumin concentrations, indocyanine green (ICG) extraction than patients without ascites. Renal vascular resistance, glomerular filtration rate, mean arterial pressure, cardiac index and systemic vascular resistance were not significantly different between the two groups. By multiple regression analysis no significant correlation was found between liver tests (i.e., prothrombin time, serum bilirubin and albumin concentrations, ICG extraction), hepatic venous pressure gradient, cardiac index and systemic vascular resistance on the one hand and renal blood flow on the other. No significant correlation was found between glomerular filtration rate and liver tests. In conclusion, in patients with cirrhosis and ascites, renal hypoperfusion is not related to the severity of liver disease.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussioncontrasting

confidence: 62%

Renal Hemodynamics in Patients with Cirrhosis: Relationship with Ascites and Liver Failure

Moreau

Gaudin

Hadengue

et al. 1993

Nephron

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“…Anaerobic metabolism and pathologic oxygen supply-consumption dependence has been documented in case of liver failure, 23 and a VO 2 -DO 2 -dependent relationship from the beginning of operation of liver transplantation until 30 minutes after reperfusion of the liver graft has been shown. 27 We observed a rather weak and inconsistent relation of DO 2 ind with any of the other study parameters, including VO 2 ind .…”

Section: Discussionmentioning

confidence: 99%

Oxygen availability during orthotopic liver transplantation

Kostopanagiotou

Smyrniotis

Theodoraki

et al. 2003

Liver Transplantation

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Studies have stressed the role of adequate tissue oxygenation in the light of an optimal patient outcome and allograft viability in liver transplantation. The practice of monitoring conventional hemodynamic parameters during liver transplantation could be complemented by parameters assessing real oxygen availability. In the present prospective study, real arterial available oxygen content (CavlO 2 ) and its extraction ratio (O 2 ERavl) were calculated. These parameters include the effect of changes in oxyhemoglobin dissociation curve (ODC; expressed by P 50 ) on oxygen availability, under the different circumstances occurring during liver transplantation. Sixteen adult cirrhotic patients were studied during orthotopic liver transplantation with the use of venovenous bypass. Classic hemodynamic measurements using a Swan-Ganz thermodilution catheter and arterial and mixed venous blood gas analysis were performed, and P 50 , oxygen deliv-

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“…Maternal mortality varies, depending on the group of patients studied, 10 to 60% (1,12) . The bleeding by rupture of esophageal varices is the most serious complication, with a serious impact on both the mother and the fetus (15) . PHT is a VO bleeding risk factors during and after pregnancy (16) .…”

Section: Discussionmentioning

confidence: 99%

Portal Hypertension and Pregnancy: Three Cases

Belaazri¹,

Lamine²,

siati³

et al. 2017

IAM

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The occurrence of pregnancy in a woman with an HTP is daunting because of the possibility of maternal and fetal worsening. The character of a high-risk pregnancy is confirmed by the frequency of gastrointestinal bleeding, spontaneous abortions and premature deliveries. Clinical symptomatology is often dominated by the complications, and the ultrasound and endoscopy, can confirm the diagnosis and detecting complications. The management of pregnancies among women with HTP must begin before conception to postpartum. It requires close collaboration between obstetricians, gastroenterologists, anesthetists and neonatologists. Our study concerns three cases of portal hypertension in pregnancy collected in the service of gynecology & obstetrics, and intensive care unit in the University Hospital Ibn Sina of Rabat. In light of these three observations, we discuss mainly, the physiopathological particularity, evolutionary aspects, and principles in the management of these pregnancies at risk.

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Abnormal tissue oxygenation in patients with cirrhosis and liver failure

Cited by 111 publications

References 31 publications

Renal Hemodynamics in Patients with Cirrhosis: Relationship with Ascites and Liver Failure

Renal Hemodynamics in Patients with Cirrhosis: Relationship with Ascites and Liver Failure

Oxygen availability during orthotopic liver transplantation

Portal Hypertension and Pregnancy: Three Cases

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