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Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting

The splanchnic and systemic hemodynamics of 14 patients with refractory ascites were studied and were compared to those of 15 patients with ascites responding to medical treatment. Among the 14 patients, 10 were grade B and 4 C, according to the Pugh classification. Of the 15 patients, 5 were Pugh B...

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Autores principales: Vons, Corinne, Hadengue, Antoine, Lee, Samuel S., Smadja, Claude, Franco, Dominique, Lebrec, Didier
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 1991
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423609/
https://www.ncbi.nlm.nih.gov/pubmed/1842670
http://dx.doi.org/10.1155/1991/16710
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author Vons, Corinne
Hadengue, Antoine
Lee, Samuel S.
Smadja, Claude
Franco, Dominique
Lebrec, Didier
author_facet Vons, Corinne
Hadengue, Antoine
Lee, Samuel S.
Smadja, Claude
Franco, Dominique
Lebrec, Didier
author_sort Vons, Corinne
collection PubMed
description The splanchnic and systemic hemodynamics of 14 patients with refractory ascites were studied and were compared to those of 15 patients with ascites responding to medical treatment. Among the 14 patients, 10 were grade B and 4 C, according to the Pugh classification. Of the 15 patients, 5 were Pugh B and 10 C. In patients with refractory ascites, free hepatic venous pressure was significantly higher and hepatic venous pressure gradient was significantly lower than in patients with responsive ascites. Hepatic and azygos blood flows were not significantly different between the two groups. Cardiac output was lower in patients with refractory ascites (p < 0.05) than in those with responsive ascites. In patients with refractory ascites, six months after peritoneovenous shunting, there was a significant reduction of wedged and free hepatic venous pressures and azygos blood flow. Cardiac output increased by 20% (p < 0.02). This study shows that hemodynamic alterations in patients with refractory ascites is the consequence of increased intraabdominal pressure due to chronic ascites. Six months after peritoneovenous shunting splanchnic and systemic hemodynamics became similar to those observed in patients without ascites.
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spelling pubmed-24236092008-07-08 Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting Vons, Corinne Hadengue, Antoine Lee, Samuel S. Smadja, Claude Franco, Dominique Lebrec, Didier HPB Surg Research Article The splanchnic and systemic hemodynamics of 14 patients with refractory ascites were studied and were compared to those of 15 patients with ascites responding to medical treatment. Among the 14 patients, 10 were grade B and 4 C, according to the Pugh classification. Of the 15 patients, 5 were Pugh B and 10 C. In patients with refractory ascites, free hepatic venous pressure was significantly higher and hepatic venous pressure gradient was significantly lower than in patients with responsive ascites. Hepatic and azygos blood flows were not significantly different between the two groups. Cardiac output was lower in patients with refractory ascites (p < 0.05) than in those with responsive ascites. In patients with refractory ascites, six months after peritoneovenous shunting, there was a significant reduction of wedged and free hepatic venous pressures and azygos blood flow. Cardiac output increased by 20% (p < 0.02). This study shows that hemodynamic alterations in patients with refractory ascites is the consequence of increased intraabdominal pressure due to chronic ascites. Six months after peritoneovenous shunting splanchnic and systemic hemodynamics became similar to those observed in patients without ascites. Hindawi Publishing Corporation 1991 /pmc/articles/PMC2423609/ /pubmed/1842670 http://dx.doi.org/10.1155/1991/16710 Text en Copyright © 1991 Hindawi Publishing Corporation. http://creativecommons.org/licenses/by/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Vons, Corinne
Hadengue, Antoine
Lee, Samuel S.
Smadja, Claude
Franco, Dominique
Lebrec, Didier
Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting
title Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting
title_full Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting
title_fullStr Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting
title_full_unstemmed Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting
title_short Splanchnic and Systemic Hemodynamics in Cirrhotic Patients With Refractory Ascites. Effect of Peritoneovenous Shunting
title_sort splanchnic and systemic hemodynamics in cirrhotic patients with refractory ascites. effect of peritoneovenous shunting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423609/
https://www.ncbi.nlm.nih.gov/pubmed/1842670
http://dx.doi.org/10.1155/1991/16710
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