Catheter Induced Error in Hepatic Venous Sampling

Sapirstein, Leo A.; Reininger, Edward J.

doi:10.1161/01.res.4.4.493

Cited by 43 publications

(14 citation statements)

References 10 publications

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“…Finally, attention may be called briefly to the results epitomized by Figure 5 and Table IV confirming in dogs under the experimental conditions of the present series the existence of a catheterization artifact as reported by Sapirstein and Reininger (23), and lending support to their general interpretation of the nature of this phenomenon. The present authors feel that a special reflex vasoconstriction is not required for interpretation of these observations but that the plasticity of blood flow distribution in the sinusoidal bed alone suffices to account for the deflection of portal flow away from a catheterized region.…”

Section: Discussionsupporting

confidence: 88%

Studies Concerning Functional Differences Between Liver Regions Supplied by the Hepatic Artery and by the Portal Vein*

Bräuer¹,

Shill²,

Krebs³

1959

J. Clin. Invest.

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The small bile ducts in the liver of a number of species are enmeshed by a vascular plexus, supplied largely by the hepatic artery (1-3). This peribiliary arterial plexus has been considered by some as evidence that the bile duct epithelia might play an important and active role in the secretion of bile, possibly even to the exclusion of the parenchymal cells (4, 5). In support of this view, it was reported that in the dog the dye sulfobromophthalein sodium (BSP) is removed more completely, and for longer periods of time, when infused into the hepatic artery than when it reaches the liver by way of the portal vein. Since the vascular pathways traversed are common for both routes of injection, except for the intercalation of the peribiliary plexus in the path of part of the arterial blood, this was the site where the extra BSP uptake was thought to take place (6). By way of interpretation the possibility was suggested that BSP is preferentially excreted into bile when taken up by the tissues supplied by this plexus, i.e., by the smaller bile ducts.No direct test of this hypothesis was undertaken, however. With the availability of S35-labeled BSP (7) the possibility suggested itself of using this material in conjunction with nonradioactive BSP to trace quantitatively two simultaneous BSP injections from two injection sites-portal vein and hepatic artery, for example-into bile, and thus to subject the concept of preferential biliary excretion of intra-arterially administered BSP to a critical test.To validate the results of any such experiments requires some further analysis of the qualitative pattern of BSP excretion into bile and of the degree to which this might vary with the route by which the dye reaches the liver, as well as of the * The opinions and assertions contained in this report are the private ones of the writers and are not to be construed as official or reflecting the views of the Navy Department or the Naval Service at large. efficiency with which the dye is removed from arterial and from portal venous blood by the liver in vivo.The present communication will deal with each of these subjects in turn, presenting validating bile secretion studies first, then the simultaneous injection experiments, and finally the extraction efficiency measurements and related studies dealing with the problem of obtaining representative hepatic vein samples. METHODSThe experiments were carried out on female mongrel dogs, 9.5 to 15.0 Kg., which had been maintained in the laboratory on commercial canned dog food for at least six weeks. They were free of acute disease, and histopathological examination showed the livers of all animals used in these experiments to be free of significant abnormalities. Intravenous sodium pentobarbital anesthesia was employed throughout, respiratory rates being maintained between 14 and 20 per minute. Rectal temperatures were maintained above 35.5°C., if necessary, by the use of hot pads; in any one animal rectal temperature fluctuations did not exceed a range of 2.5°C.Injections were made ...

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Section: Discussionsupporting

confidence: 88%

Studies Concerning Functional Differences Between Liver Regions Supplied by the Hepatic Artery and by the Portal Vein*

Bräuer¹,

Shill²,

Krebs³

1959

J. Clin. Invest.

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“…It was suggested [14] that in some patients with nonalcoholic cir rhosis, PHG may be different from portal pressure measured using a thin needle ad vanced into the portal system through the liv er, but other authors [15,16] did not report any differences between PHG and direct por tal pressure measurement in similar condi tions. Although the measurement of EHBF using ICG constant infusion is not completely free from criticism because of some inaccura cies [17,18], it remains the reference tech nique and was used in other studies on the hemodynamic effects of SRIF [3,4,7], In our series, SRIF decreased EHBF, but did not modify the levels of portal hyperten sion. A decrease in EHBF during SRIF infu sion was already demonstrated by other au thors, both in experimental animals [19,20] and in normal subjects [7,21], and in pa tients with liver cirrhosis and portal hyper tension [3,4], although Sonnenberg et al [7] found that SRIF had no effect in the latter condition.…”

Section: Discussionmentioning

confidence: 98%

Effect of Somatostatin on Splanchnic Hemodynamics in Patients with Liver Cirrhosis and Portal Hypertension

et al. 1985

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The effect of somatostatin on splanchnic hemodynamics in patients with liver cirrhosis is not clearly defined, as some authors report a decrease in portal pressure and in liver blood flow during intravenous administration of this hormone, while others do not. In 19 subjects with liver cirrhosis and portal hypertension the following parameters were measured before and during intravenous administration of somatostatin (7.5 μg/min): porto-hepatic gradient, estimated hepatic blood flow, specific splenic blood flow, cardiac index. Estimated hepatic blood flow decreased significantly during somatostatin infusion (p < 0.05), averaging a 13% decrease; porto-hepatic gradient, splenic specific blood flow and cardiac index did not vary significantly. These data indicate that somatostatin infused at a dose of 7.5 μg/min induces a slight decrease in liver blood flow without affecting portal hypertension.

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“…The problem of the clearance techniques using dyes is the extrahepatic loss which is smallest using indocyanine green as indicator even in patients suffering from hepatic cirrhosis (Preisig, Rankin, Sweeting & Bradley, 1966;Reemtsma, Hollinger, de Graff & Creech, 1960). The necessity of hepatic vein catheterization, which is possible in about 90% of patients under fluoroscopic control (Reynolds, Redeker & Geller, 1957) (Sapirstein & Reininger, 1956). The deeper the catheter and the closer to wedging the lower the values obtained.…”

Section: A) Clearance Techniquementioning

confidence: 99%

Methods of the assessment of the effect of drugs on liver blood flow in man.

Ohnhaus¹

1979

Brit J Clinical Pharma

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Catheter Induced Error in Hepatic Venous Sampling

Cited by 43 publications

References 10 publications

Studies Concerning Functional Differences Between Liver Regions Supplied by the Hepatic Artery and by the Portal Vein*

Studies Concerning Functional Differences Between Liver Regions Supplied by the Hepatic Artery and by the Portal Vein*

Effect of Somatostatin on Splanchnic Hemodynamics in Patients with Liver Cirrhosis and Portal Hypertension

Methods of the assessment of the effect of drugs on liver blood flow in man.

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