Effects of Acute Portal Hypertension by Portal Venous Stenosis on Systemic Hemodynamics in Dogs

Moriura, Shigeaki; Nimura, Y; Kato, Masamitsu; Sato, Tomoyuki; Shionoya, S

doi:10.1159/000129090

Cited by 11 publications

(8 citation statements)

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“…11,12 It is well known that clamping of the inferior vena cava vein and portal vein causes an significant elevation of venous pressures (Table 3) and damages both the gastrointestinal mucosa (Fig. 1) and the abdominal organs because of the release of chinines, cytokines (tumor necrosis factor, interleukin), and vasoactive mediators, [13][14][15] which may also interfere with the cardiocirculatory function, 16,17 but there is actually evidence that a correct anaesthesiologic protocol, especially in regard to analgesia and fluid management, improves the outcome of animals after clamping and activation of the porto-intracaval shunt.…”

Section: Discussionmentioning

confidence: 99%

Experimental anaesthesiologic protocol for porto‐intracaval shunt for liver total vascular exclusion: Preliminary study in the rabbit

et al. 2001

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The aim of this study was to evaluate the effects and interference of different anaesthetic techniques in rabbits undergoing liver total vascular exclusion using a porto-intracaval shunt. Twenty New Zealand rabbits were divided in three groups: group A receiving diazepam as premedication, ketamine + atropine for induction and maintenance of anaesthesia and undergoing a porto-intracaval shunt operation; group B receiving midazolam as premedication, ketamine + fentanyl + atropine for induction and maintenance of anaesthesia and undergoing a porto-intracaval shunt operation; group C receiving the same drugs as group B but undergoing a simple portal and caval clamping. The following parameters were studied: efficacy of premedication, vital parameters before and after clamping and insertion of the shunt, mean time to clamp and insert the shunt, mean survival time after clamping (group C) or activation of the shunt (groups A and B). Midazolam was significantly better for premedication; there was no statistically significant difference between groups A and B for the vital parameters, for the time necessary to clamp and insert the shunt, for the intraoperative course, and for the mean survival time. The absence of a statistically significant difference between groups could be due to the low number of animals used in the study. There is actually evidence that a correct anaesthesiologic protocol, especially referring to analgesia and fluid management, improves the outcome of operated animals. Surely further studies, possibly conducted on a larger number of animals, are required to evaluate better the results observed and to consider applying these data and this experience to humans.

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Section: Discussionmentioning

confidence: 99%

Experimental anaesthesiologic protocol for porto‐intracaval shunt for liver total vascular exclusion: Preliminary study in the rabbit

et al. 2001

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“…17 Moriura et al experimentally analyzed hemodynamic changes after artificial portal vein stenosis, and showed that a sudden increase in portal vein pressure of about twice normal causes a statistically significant decrease of approximately 1 mmHg in right arterial pressure, as well as a 24% decrease in cardiac output. 18 If we consider that the liver receives approximately 25% of cardiac output, we can assume that portal vein clamping is associated with this indirect reduction in arterial blood flow of about 25%. 19 Thus, acute portal hypertension could initially be associated with liver arterial hypoperfusion.…”

Section: à13mentioning

confidence: 99%

“…20 When the caval vein is also clamped, the reduction in venous inflow to the heart is higher (75%); cardiac output is thus greatly reduced, and rapidly leads to the death of the animal. 18 Because of this, prolonged portal venous stenosis results in high mortality. However, Monchik et al showed that ischemia time of up to 1 h does not adversely affect the microscopic appearance of the bowel.…”

Section: à13mentioning

confidence: 99%

Training protocol for feline renal transplantation, using rat vascular anastomosis

Iwai¹,

Endo²,

Kobayashi

2006

Microsurgery

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Renal transplantation (RTx) has been a potential treatment for renal failure in pet cats. We developed a training protocol for the microsurgical skills required for feline RTx using rat vessels, which are the same size as the feline renal artery and vein. Using interrupted sutures, the transected abdominal aorta was reestablished in an end-to-end fashion. Venous anastomosis was performed with a continuous running suture in an end-to-side fashion between the portal vein and inferior vena cava. In the arterial anastomotic model, technical errors were checked by postoperative hemorrhaging. Those failures in the venous anastomotic model, technical errors were confirmed by the rat's death. Histological examinations of the epithelialization at the anastomotic site were evaluated in both groups. After training, nine cases of feline RTx were performed safely, using an adequate microsurgical technique.

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“…Acute portal hypertension may also determine systemic hemodynamic disturbances such as decreased venous return and systemic arterial pressure -the situation can induce splanchnic hypoperfusion and resultant change in mucosal histology -and motility. In addition, Moriura et al 11 showed a reduction in cardiac output and maintenance of left atrial pressure, suggesting no decrease in venous return. Thus, the mechanisms of hemodynamic changes after partial occlusion of the portal vein remain controversial.…”

mentioning

confidence: 99%

Atividade mioelétrica do intestino delgado de cães submetidos à oclusão parcial da veia porta

Ferraz¹,

Campos²,

Evangelista³

et al. 2011

ABCD, arq. bras. cir. dig.

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-Background -Temporary occlusion of the portal vein causes splancnic venous stasis and intestinal disfunction, that can produce alterations in the motility, and this fact is not vastly known. Aim -To evaluate the small bowel myoelectric activity and histology in the six dogs, also covering mean arterial blood pressure (AP), pulse rate (PR), central venous pressure (CVP) e portal pressure (PP), in two phases: pre-occlusion and occlusion. Methods -It was done general anesthesia, invasive monitorization of the AP, PR e CVP, laparotomy, measure of the PP, fixation of the three pairs of electrodes in the intestinal wall, jejunal biopsy and parcial occlusion of the portal vein, being programmed the increase of the PP between 2.5 and 3 times baseline. Electrodes were connected to a computer system that captured electrical signals from the intestine. The computer has a software of acquisition to store and analyse the myoelectric activity after registering, what happened in 30 minutes of the preocclusion phase and in 60 minutes of occlusion. The variance and the mean RMS (root mean square) of the myoeletric activity were determined. The statistical analysis was done with Friedman, Dunn, Cochran and Students t tests. Results -Mean RMS of myoeletric activity showed significant decrease in the phase of portal occlusion, in comparison to pre-occlusion phase. The frequency of hemorrhage of the lamina propria was major during occlusion.It was proportional at stasis time, with significant difference between the pre-occlusion and the occlusion of 60 minutes. Inflammatory infiltration, vascular dilation and epithelial detachment did not show any differences between two phases. During the stasis, AP, PR and CVP decreased (p=0,326; 0,375 e 0,008, respectively), and PP increased (p=0,015). Conclusions -Parcial occlusion of the portal vein produced reduction of the myoeletric activity and elevation of the percentage frequency of hemorrhage in lamina propria, and a fall of CVP, with relative hemodynamic stabilization.Resumo -Racional -A oclusão temporária da veia porta causa estase esplâncnica e pode causar dismotilidade intestinal. Objetivo -Avaliar as alterações da atividade mioelétrica e da histologia do intestino delgado, além da pressão arterial média (PAM), frequência cardíaca (FC), pressão venosa central (PVC) e pressão portal (PP), na fase de pré-oclusão e de oclusão portal. Método -Realizou-se anestesia geral em seis cães, seguido de monitorização da PAM, FC e PVC, laparotomia, aferição da PP, fixação de três pares de eletrodos na parede intestinal, biópsias jejunais e oclusão parcial da veia porta, sendo programado aumento da PP entre 2,5 e 3 vezes. Os eletrodos foram conectados a um microcomputador com software de aquisição para armazenamento e análise da atividade mioelétrica, cujo registro ocorreu nos 30 minutos da fase de pré-oclusão e nos 60 minutos de oclusão. Determinouse a variância e a média do RMS (root mean square) da atividade mioelétrica. Resultados -Na fase de oclusão, houve diminuição significativa da...

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Effects of Acute Portal Hypertension by Portal Venous Stenosis on Systemic Hemodynamics in Dogs

Cited by 11 publications

References 0 publications

Experimental anaesthesiologic protocol for porto‐intracaval shunt for liver total vascular exclusion: Preliminary study in the rabbit

Experimental anaesthesiologic protocol for porto‐intracaval shunt for liver total vascular exclusion: Preliminary study in the rabbit

Training protocol for feline renal transplantation, using rat vascular anastomosis

Atividade mioelétrica do intestino delgado de cães submetidos à oclusão parcial da veia porta

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