Wedged hepatic venous pressure

Reynolds, Telfer B.; Redeker, Allan G.; Geller, Herman M.

doi:10.1016/0002-9343(57)90090-6

Cited by 80 publications

(8 citation statements)

References 9 publications

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“…This belief has been corroborated by parallel falls in inferior vena cava and wedged hepatic vein pressure with paracentesis (17,18). the results of wedged hepatic vein pressure measurements in the present study, these workers did not find any difference in directly measured portal pressure in these two groups.…”

Section: Introductionsupporting

confidence: 82%

Effective plasma volume in cirrhosis with ascites. Evidence that a decreased value does not account for renal sodium retention, a spontaneous reduction in glomerular filtration rate (GFR), and a fall in GFR during drug-induced diuresis

Lieberman¹,

Ito²,

Reynolds³

1969

J. Clin. Invest.

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110

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Section: Introductionsupporting

confidence: 82%

Effective plasma volume in cirrhosis with ascites. Evidence that a decreased value does not account for renal sodium retention, a spontaneous reduction in glomerular filtration rate (GFR), and a fall in GFR during drug-induced diuresis

Lieberman¹,

Ito²,

Reynolds³

1969

J. Clin. Invest.

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110

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“…Larger doses of ICI 118551 might produce greater falls in pressure but because the ,32-adrenoceptor selectivity becomes progressively less about 50 mg, its advantage over propranolol would be lost. Nevertheless, given the absence of a correlation between single measurements of portal pressure and variceal bleeding (Reynolds et al, 1957;Lebrec et al, 1980), the value of reducing resting portal pressure by such minor decrements is questionable. Indeed, Jenkins et al (1982) have been unable to confirm the beneficial effects of propranolol in the prevention of variceal bleeding, and a trial of /81-selective adrenoceptor blockade using metoprolol has also shown little reduction in the frequency of rebleeding .…”

Section: Discussionmentioning

confidence: 99%

Reductions in portal pressure by selective beta 2‐adrenoceptor blockade in patients with cirrhosis and portal hypertension.

Bihari¹,

Westaby²,

Gimson³

et al. 1984

Brit J Clinical Pharma

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1 In order to elucidate the mechanisms by which 18-adrenoceptor blockade leads to a reduction in portal pressure, we have measured portal pressure, heart rate and cardiac index in 17 patients with cirrhosis and portal hypertension following the oral administration of the selective ,82-adrenoceptor blocking agent, ICI 118551, in the two dosage ranges 10-20 mg and 50-100 mg. 2 There was a fall in portal pressure in 14 of the 17 patients from a median of 17 mm Hg to a median of 15 mm Hg, P < 0.01, that occurred only at 60 min following administration of the drug. 3 Although there were early systemic haemodynamic changes, with a significant fall in heart rate and cardiac index from before to 30 min after the ingestion of ICI 118551 (median heart rates 86 and 80 beats/min respectively, P < 0.01, median cardiac indices 3.5 and 3.3 1 min-' m-2, P < 0.05), these occurred before the fall in portal pressure and were unrelated to changes in portal pressure. 4 This reduction in portal pressure independent of systemic haemodynamic changes is consistent with 132-adrenoceptor blockade within the splanchnic and hepatic arterial circulations; subsequent increases in splanchnic and hepatic arterial resistances with a concomitant fall in portal blood flow and hepatic portal resistance may lead to the reduction in portal pressure.

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“…Subsequent patients evaluated before and after or during portacaval shunt received internal therapeutic end-to-side portacaval anastomosis after endoscopically documented variceal hemorrhage (17). In our institution umbilical vein catheterization is the preferred method for evaluating the portal circulation because of its safety and reliability (18) (20,21). The achievement of a wedged position was confirmed by the demonstration of an arterial pulse in the pressure recording, by the identity of wedged hepatic venous pressure and portal pressure, and by injection of radiopaque contrast at the completion of a study.…”

Section: Methodsmentioning

confidence: 99%

Effect of Portal Venous Blood Flow Diversion on Portal Pressure

Zimmon¹,

Kessler²

1980

J. Clin. Invest.

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A B S T R A C T To anticipate the hepatic vascular response to portacaval anastomosis, we studied portal pressure during diversion of portal blood through a temporary extracorporeal umbilical vein to saphenous vein shunt. The relationship of portal pressure to shunted flow was approximately linear. In five schistosomiasis patients (controls) portal diversion to 1,250 ml/min gave portal pressure-shunted flow curve slopes ranging from 0.13 to 0.57 cm water/100 ml per min (0.31±0.18, mean+SD). In 17 cirrhotic patients with portal hypertension a continuum of slopes was observed from within mean±2 SD of control (type A) to larger slopes (type B) indicating failure of portal pressure regulation. When portal flow was augmented by shunting from saphenous vein to portal vein, cirrhotic patients who had slopes less than mean ±2 SD ofcontrols during diversion (type A) exhibited a compliant system with small increases in portal pressure, whereas type B patients had significantly greater pressure increases. Selective investigations suggested that changes in portal pressure provoked compensatory changes in hepatic arterial blood flow that tended to maintain portal pressure at a set point. Type B patients demonstrated failure of this mechanism to varying degrees.After end-to-side portacaval shunt, seven type A cirrhotic patients maintained residual intrahepatic venous pressure unchanged from prior portal pressure, whereas six type B patients had a significant decrease. Residual intrahepatic venous pressure was measured after portacaval shunt in 40 cirrhotic patients who were followed This work was presented in part at the annual meetings of the American Association for the Study of Liver Disease,

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Wedged hepatic venous pressure

Cited by 80 publications

References 9 publications

Effective plasma volume in cirrhosis with ascites. Evidence that a decreased value does not account for renal sodium retention, a spontaneous reduction in glomerular filtration rate (GFR), and a fall in GFR during drug-induced diuresis

Effective plasma volume in cirrhosis with ascites. Evidence that a decreased value does not account for renal sodium retention, a spontaneous reduction in glomerular filtration rate (GFR), and a fall in GFR during drug-induced diuresis

Reductions in portal pressure by selective beta 2‐adrenoceptor blockade in patients with cirrhosis and portal hypertension.

Effect of Portal Venous Blood Flow Diversion on Portal Pressure

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