Effects of dobutamine on hepatosplanchnic hemodynamics in patients with chronic liver disease. 1994

T Kawasaki, and F Moriyasu, and T Kimura, and H Someda, and N Hamato, and M Okuma
First Dept. of Medicine, Faculty of Medicine, Kyoto University, Japan.

BACKGROUND It is said that catecholamines increase hepatic blood flow in patients without liver diseases, although several reports have suggested a blunted response to catecholamines in patients with liver cirrhosis. METHODS We investigated changes in splanchnic blood flow distribution induced by the infusion of dobutamine into peripheral veins of healthy adults (NC group), patients with chronic hepatitis (CH group), and patients with liver cirrhosis (LC group), using a Doppler duplex system (protocol 1). We also investigated changes in hepatic hemodynamics induced by dobutamine infusion in patients with liver cirrhosis (cirrhosis group) and patients without liver diseases (control group), using hepatic catheterization (protocol 2). RESULTS In protocol 1 the average increase in portal venous blood flow during dobutamine infusion was significant in the NC and CH groups but was not significant in the LC group. Changes in the blood flow in the splenic artery and vein, superior mesenteric artery and vein, and femoral artery were similar to those in the portal vein in each of the three groups. Infusion did not cause a change in the common hepatic arterial flow in any of the three groups. In protocol 2 the portal venous flow, cardiac index, and hepatic venous pressure gradient increased significantly during dobutamine infusion in both the cirrhosis and the control groups. Hepatic vascular resistance in the cirrhosis group increased slightly, whereas, in contrast, that in the control group increased significantly. The rate of change in almost all variables was lower in the cirrhosis group than in the control group. CONCLUSIONS These results indicate that dobutamine has less effect on hepatic circulation in patients with liver cirrhosis than in those without liver diseases, indicating that the value of dobutamine in increasing hepatic blood flow in cirrhotic patients is very limited.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008102 Liver Circulation The circulation of BLOOD through the LIVER. Hepatic Circulation,Circulation, Liver,Circulation, Hepatic
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011168 Portal System A system of vessels in which blood, after passing through one CAPILLARY BED, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system. Portal Systems,System, Portal,Systems, Portal
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D002406 Catheterization, Peripheral Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes. Arterial Catheterization, Peripheral,Catheterization, Bronchial,Catheterization, Peripheral Arterial,Catheterization, Peripheral Venous,Peripheral Catheterization,Venous Catheterization, Peripheral,Bronchial Catheterization,PICC Line Catheterization,PICC Line Placement,PICC Placement,Peripheral Arterial Catheterization,Peripheral Venous Catheterization,Peripherally Inserted Central Catheter Line Insertion,Arterial Catheterizations, Peripheral,Bronchial Catheterizations,Catheterization, PICC Line,Catheterizations, Bronchial,Catheterizations, PICC Line,Catheterizations, Peripheral,Catheterizations, Peripheral Arterial,Catheterizations, Peripheral Venous,PICC Line Catheterizations,PICC Line Placements,PICC Placements,Peripheral Arterial Catheterizations,Peripheral Catheterizations,Peripheral Venous Catheterizations,Placement, PICC,Placement, PICC Line,Placements, PICC,Placements, PICC Line,Venous Catheterizations, Peripheral
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic

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