Small bowel and liver gas tensions during intravenous vasopressin infusion and 60% oxygen ventilation

Korsbäck, C; Höckerstedt, K

doi:10.1007/bf01852383

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…In fact, AVP has been traditionally employed to decrease perfusion of the hepatosplanchnic system in patients with bleeding esophageal varices (5). Similar to our observations, previous studies demonstrated that AVP not only reduces blood flow in a dose-dependent manner but also decreases small bowel PO 2 and diminishes the arteriovenous oxygen content difference in the gut (11,22,23,34).…”

Section: Discussionsupporting

confidence: 86%

Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension

Knotzer¹,

Pajk²,

Maier³

et al. 2005

American Journal of Physiology-Heart and Circulatory Physiology

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We investigated intestinal oxygen supply and mucosal tissue PO2 during administration of increasing dosages of continuously infused arginine vasopressin (AVP) in an autoperfused, innervated jejunal segments in anesthetized pigs. Mucosal tissue PO2 was measured by employing two Clark-type surface oxygen electrodes. Oxygen saturation of jejunal microvascular hemoglobin was determined by tissue reflectance spectrophotometry. Microvascular blood flow was assessed by laser-Doppler velocimetry. Systemic hemodynamic variables, mesenteric venous and systemic acid-base and blood gas variables, and lactate measurements were recorded. Measurements were performed at baseline and at 20-min intervals during incremental AVP infusion (n = 8; 0.007, 0.014, 0.029, 0.057, 0.114, and 0.229 IU.kg(-1).h(-1), respectively) or infusion of saline (n=8). AVP infusion led to a significant (P < .05), dose-dependent decrease in cardiac index (from 121 +/- 31 to 77 +/- 27 ml.kg(-1).min(-1) at 0.229 IU.kg(-1).h(-1)) and systemic oxygen delivery (from 14 +/- 3 to 9 +/- 3 ml.kg(-1).min(-1) at 0.229 IU.kg(-1).h(-1)) concomitant with an increase in systemic oxygen extraction ratio (from 31 +/- 4 to 48 +/- 10%). AVP decreased microvascular blood flow (from 133 +/- 47 to 82 +/- 35 perfusion units at 0.114 IU.kg(-1).h(-1)), mucosal tissue PO2 (from 26 +/- 7 to 7 +/- 2 mmHg at 0.229 IU.kg(-1).h(-1)), and microvascular hemoglobin oxygen saturation (from 51 +/- 9 to 26 +/- 12% at 0.229 IU.kg(-1).h(-1)) without a significant increase in mesenteric venous lactate concentration (2.3 +/- 0.8 vs. 3.4 +/- 0.7 mmol/l). We conclude that continuously infused AVP decreases intestinal oxygen supply and mucosal tissue PO2 due to a reduction in microvascular blood flow and due to the special vascular supply in the jejunal mucosa in a dose-dependent manner in pigs.

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Section: Discussionsupporting

confidence: 86%

Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension

Knotzer¹,

Pajk²,

Maier³

et al. 2005

American Journal of Physiology-Heart and Circulatory Physiology

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“…However, during organ harvesting, diuresis is considered a valuable sign of adequate kidney perfusion (8). Also, ADH is known to cause vasoconstriction and even hypoxia in the splanchnic bed (9). The significance of it is obscure in the liver donor.…”

Section: Discussionmentioning

confidence: 99%

Peroperative fluid management of the brain‐dead multiorgan donor

Randell

Orko

Höckerstedt

1990

Acta Anaesthesiol Scand

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Brain-dead organ donors are often dehydrated and have serum electrolyte disorders. This study was designed to analyse the haemodynamic condition and serum electrolyte balance of liver donors. Two different fluid management plans for the harvesting operation were studied. Sixteen consecutive organ donors were included. They were randomly infused either with a combination of colloid (hydroxy ethyl starch) and electrolyte solution (group COL) or with crystalloid fluid alone (group CR). Arterial pressures, heart rate, central venous pressure and oesophageal temperature were monitored and serum electrolytes were analysed before the beginning of the operation and during harvesting. The amount of fluid needed in the COL group was significantly less (P less than 0.01) than in the CR group. There were no statistical differences between the groups in the haemodynamic parameters during the study period. The oesophageal temperature was maintained in both groups. All donors were initially hypernatraemic, but the serum sodium values returned towards normal during surgery in both groups. Immediate function was seen in all livers. In conclusion, the haemodynamic stability is maintained with a smaller infused volume if hydroxyethyl starch is combined with crystalloid fluids. The formation of interstitial oedema will be less when colloids are used, but its significance in organ donation needs further evaluation.

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Haemodynamic Effects of a Long-Acting Somatostatin Analogue in Patients with Liver Cirrhosis

Eriksson

Brundin

Söderlund

et al. 1987

Scandinavian Journal of Gastroenterology

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The influence of SMS 201-995 (octreotide, Sandostatin), a long-acting somatostatin analogue, on splanchnic haemodynamics was studied in 15 patients with liver cirrhosis and in 5 healthy individuals before, during, and after 60 min of intravenous SMS infusion (25 and 50 micrograms/h, respectively). No adverse effects of the SMS infusion were seen. In the basal state the estimated hepatic blood flow was 1.04 +/- 0.08 l/min (mean +/- SE) in the patients and 1.62 +/- 0.09 l/min (P less than 0.001) in the controls. At 15 min after the beginning of the infusion the blood flow had already decreased by 15-30% (P less than 0.05-0.01). The reduction was more marked in controls than in patients, and it persisted in both groups during and for 60 min after the infusion. Wedged hepatic venous pressure, measured in the patients, was 20 +/- 2 mmHg in the basal state and 18 +/- 1 mmHg during the infusion (P less than 0.05), and it remained at this level for 60 min after the infusion. Free hepatic venous pressure was unchanged throughout the study. Splanchnic oxygen uptake was similar in the two groups in the basal state and remained unaltered during and after SMS infusion. Both heart rate and arterial systolic and diastolic blood pressure remained unchanged during SMS administration. In summary, SMS infusion results in a fall in hepatic blood flow and a slight but significant decrease in wedged hepatic venous pressure, whereas no effect was noted on the systemic circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

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Small bowel and liver gas tensions during intravenous vasopressin infusion and 60% oxygen ventilation

Cited by 3 publications

References 14 publications

Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension

Arginine vasopressin reduces intestinal oxygen supply and mucosal tissue oxygen tension

Peroperative fluid management of the brain‐dead multiorgan donor

Haemodynamic Effects of a Long-Acting Somatostatin Analogue in Patients with Liver Cirrhosis

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