Effects of transjugular intrahepatic portosystemic shunt (TIPS) on blood volume distribution in patients with cirrhosis

Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. To investigate effects of TIPS on regional...

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Published in:Digestive and liver disease 2017-12, Vol.49 (12), p.1353-1359
Main Authors: Busk, Troels M., Bendtsen, Flemming, Henriksen, Jens H., Fuglsang, Stefan, Clemmesen, Jens O., Larsen, Fin S., Møller, Søren
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Language:English
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Central blood volume
Chronic liver disease
Portal hypertension
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description Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. To investigate effects of TIPS on regional blood volume distribution, and systemic haemodynamics. Thirteen cirrhotic patients had their regional blood volume distribution determined with gamma-camera technique before and after TIPS. Additionally, we measured systemic haemodynamics during liver vein and right heart catheterization. Central and arterial blood volume (CBV) and cardiac output (CO) were determined with indicator dilution technique. After TIPS, the thoracic blood volume increased (+10.4% of total blood volume (TBV), p
doi_str_mv 10.1016/j.dld.2017.06.011
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A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. To investigate effects of TIPS on regional blood volume distribution, and systemic haemodynamics. Thirteen cirrhotic patients had their regional blood volume distribution determined with gamma-camera technique before and after TIPS. Additionally, we measured systemic haemodynamics during liver vein and right heart catheterization. Central and arterial blood volume (CBV) and cardiac output (CO) were determined with indicator dilution technique. After TIPS, the thoracic blood volume increased (+10.4% of total blood volume (TBV), p<0.01), whereas the splanchnic blood volume decreased (−11.9% of TBV, p<0.001). CO increased (+22%, p<0.0001), and systemic vascular resistance decreased (−26%, p<0.001), whereas CBV did not change. Finally, right atrial pressure and mean pulmonary artery pressure increased after TIPS (+50%, p<0.005; +40%, p<0.05, respectively). 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subjects Central blood volume
Chronic liver disease
Portal hypertension
title Effects of transjugular intrahepatic portosystemic shunt (TIPS) on blood volume distribution in patients with cirrhosis
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