Hemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis

Angelo Luca, Isabel Cirera, Juan Carlos García-Pagán, Fausto Feu, Pilar Pizcueta, Jaime Bosch, Juan Rodés

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Abstract

Background: Changes in intra-abdominal pressure (IAP) have significant circulatory effects. However, whether this may influence the gastroesophageal collateral blood flow in patients with cirrhosis has not been studied. Methods: In 14 portal hypertensive cirrhotics, serial hemodynamic measurements were obtained in baseline conditions 30 minutes after the mechanical increase of IAP by 10 mm Hg and 30 minutes after returning IAP to baseline levels. Results: Increasing IAP caused similar increases in free and wedged hepatic venous pressures (+10.3 mm Hg and +11.0 mm Hg, respectively; P <0.005), without changing the hepatic venous pressure gradient (HVPG). However, there were significant decreases in cardiac output (-18%; P <0.005) and hepatic blood flow (-20%; P <0.05), whereas azygos blood flow, an index of gastroesophageal collateral blood flow, increased markedly (+23%; P <0.005). The opposite occurred after releasing the high IAP. Conclusion: In portal hypertensive cirrhotics, acute changes in IAP did not change HVPG but markedly modified splanchnic and systemic hemodynamics. Brief elevations of IAP may have deletereous effects, as shown by the increase in azygos blood flow and the decrease in cardiac output and hepatic blood flow, whereas reduction of a high IAP causes the opposite changes and may be beneficial.

Original languageEnglish
Pages (from-to)222-227
Number of pages6
JournalGastroenterology
Volume104
Issue number1
Publication statusPublished - 1993

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Fibrosis
Hemodynamics
Pressure
Venous Pressure
Liver
Cardiac Output
Viscera

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Luca, A., Cirera, I., García-Pagán, J. C., Feu, F., Pizcueta, P., Bosch, J., & Rodés, J. (1993). Hemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis. Gastroenterology, 104(1), 222-227.

Hemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis. / Luca, Angelo; Cirera, Isabel; García-Pagán, Juan Carlos; Feu, Fausto; Pizcueta, Pilar; Bosch, Jaime; Rodés, Juan.

In: Gastroenterology, Vol. 104, No. 1, 1993, p. 222-227.

Research output: Contribution to journalArticle

Luca, A, Cirera, I, García-Pagán, JC, Feu, F, Pizcueta, P, Bosch, J & Rodés, J 1993, 'Hemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis', Gastroenterology, vol. 104, no. 1, pp. 222-227.
Luca A, Cirera I, García-Pagán JC, Feu F, Pizcueta P, Bosch J et al. Hemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis. Gastroenterology. 1993;104(1):222-227.
Luca, Angelo ; Cirera, Isabel ; García-Pagán, Juan Carlos ; Feu, Fausto ; Pizcueta, Pilar ; Bosch, Jaime ; Rodés, Juan. / Hemodynamic effects of acute changes in intra-abdominal pressure in patients with cirrhosis. In: Gastroenterology. 1993 ; Vol. 104, No. 1. pp. 222-227.
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