Pharmacologic therapy for portal hypertension

Lowe, Robert; Grace, Norman D.

doi:10.1007/s11894-001-0037-0

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…Outcomes were in line with hyperdynamic system circulation hypothesis and awareness that patients with milder liver injury show lesser abnormalities within system [19,20] and the development of adrenergic neuropathy [21]. A growing number of studies report on positive therapeutic results with the use of nonselective beta-blockers [22,23] that decrease portal pressure and collateral flow. The blockade of cardiac beta-1 adrenoreceptors slows the heart rate and secondarily decreases the minute volume [24].…”

Section: Discussionsupporting

confidence: 57%

Doppler Ultrasound of Hepatic and System Hemodynamics in Patients with Alcoholic Liver Cirrhosis

et al. 2009

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In patients with liver cirrhosis there is an inversely reciprocal relationship of conjugated HARI with PVFV, correlating to disease grade. PVFV in cirrhosis decreases and HARI values were over 0.7. Study demonstrated that combining echocardiography with abdominal Doppler ultrasound served as valuable non-invasive diagnostic insight in liver and systemic circulation among different grade of cirrhosis.

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Section: Discussionsupporting

confidence: 57%

Doppler Ultrasound of Hepatic and System Hemodynamics in Patients with Alcoholic Liver Cirrhosis

et al. 2009

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“…The wall tension (T ) in a varix varies may be related to the transmural pressure (TP), vessel radius (r ), and wall thickness (w), which is represented by LaPlace's law: T = TP × (r/w) (12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

Portal Venous Flow Pattern as a Useful Tool for Predicting Esophageal Varix Bleeding in Cirrhotic Patients

2005

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This study aimed to evaluate whether (1) the portal venous flow pattern determined by color Doppler sonography could be related to the clinical severity of liver cirrhosis and (2) whether the flow patterns differ between patients with bleeding and nonbleeding esophageal varices. One hundred twenty-nine cirrhotic patients and 60 noncirrhotic healthy controls were enrolled after endoscopic survey for the presence of esophageal varices. Each patient received color Doppler echography to define the pattern of blood flow direction as hepatopetal or nonhepatopetal (hepatofugal, turbulence, and bidirection) in type. The patients with esophageal varices were further categorized into two groups: with recent bleeding (BEV; n = 99) and without recent bleeding (NBEV; n = 30). More patients in the BEV group (72.7%) had a nonhepatopetal Doppler flow pattern than in the control group (1.7%) and NBEV group (13.3%) (P < 0.001). Among the 129 cirrhotic patients, the nonhepatopetal flow pattern of the portal vein was higher in 96% of Child-Pugh grade C patients than in 41.8% of grade A patients and 57.6% of grade B patients (P < 0.05). Moreover, for those cirrhotic patients with Child-Pugh grades A and B, the nonhepatopetal Doppler flow pattern was more commonly found in the BEV group than in the NBEV group (63.0 vs. 13.8%; odds ratio, 10.64; 95% CI, 0.03-0.299; P < 0.001). Portal venous blood flow pattern is related to severity of cirrhosis. The presence of a nonhepatopetal flow pattern implicates an increased risk of esophageal varices bleeding, especially for those cirrhotic patients with Child-Pugh grades A and B.

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“…Anhand der Parameter der systemischen Hämodynamik lässt sich keine zu- [35]. Infolgedessen stellt sich die Frage, ob AVP und TP -wenn sie in der Sepsis verabreicht werden -ebenfalls den mesenterialen Blutfluss reduzieren.…”

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Einsatz von Vasopressin und Terlipressin bei Sepsis und systemischen Entzündungsreaktionen

et al. 2005

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Vasopressin and terlipressin are increasingly used as alternative non-adrenergic vasopressors for hemodynamic support of septic patients with arterial hypotension. Despite excellent vasopressive effects, vasopressin analogues may potentially impair macro-hemodynamics, oxygen transport and microvascular blood flow. Due to those unwanted side-effects, vasopressin and terlipressin may potentially compromise organ function and possibly foster the development of multiple organ failure. This review article discusses the results of clinical and experimental studies to judge the effects of vasopressin and terlipressin on microcirculation, oxygen supply, metabolism and organ function in patients with sepsis or systemic inflammatory response syndrome (SIRS). Although vasopressin analogues are emerging as promising alternatives to treat catecholamine-refractory hypotension, there is no evidence that vasopressin receptor agonists improve outcome. To date, vasopressin and terlipressin can, therefore, not be recommended for routine clinical use.

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Pharmacologic therapy for portal hypertension

Cited by 4 publications

References 36 publications

Doppler Ultrasound of Hepatic and System Hemodynamics in Patients with Alcoholic Liver Cirrhosis

Doppler Ultrasound of Hepatic and System Hemodynamics in Patients with Alcoholic Liver Cirrhosis

Portal Venous Flow Pattern as a Useful Tool for Predicting Esophageal Varix Bleeding in Cirrhotic Patients

Einsatz von Vasopressin und Terlipressin bei Sepsis und systemischen Entzündungsreaktionen

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