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Related Experiment Videos

Clinical review: splanchnic ischaemia.

Stephan M Jakob1

  • 1Department of Intensive Care Medicine, University Hospital, Bern, Switzerland. stephan.jakob@insel.ch

Critical Care (London, England)
|September 13, 2002
PubMed
Summary
This summary is machine-generated.

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Impaired splanchnic perfusion, common in critical illness, increases patient risk. This review explores splanchnic vasoregulation, including the hepatic arterial buffer response (HABR), and discusses new trials.

Area of Science:

  • Critical care medicine
  • Gastroenterology
  • Hepatology

Background:

  • Inadequate splanchnic perfusion is linked to higher morbidity and mortality, especially with coexisting liver dysfunction.
  • Conditions like heart failure, increased intra-abdominal pressure, hemodialysis, and obstructive sleep apnea impair splanchnic perfusion in critically ill patients.
  • The hepatic arterial buffer response (HABR), which protects total liver blood flow by increasing hepatic arterial flow as portal venous flow decreases, may be compromised in certain conditions.

Purpose of the Study:

  • To review current understanding of splanchnic vasoregulation.
  • To discuss experimental and clinical viewpoints on hepato-splanchnic blood flow.
  • To examine recent clinical trials in this area.

Main Methods:

Related Experiment Videos

  • Literature review of old and new concepts in splanchnic vasoregulation.
  • Discussion of experimental and clinical evidence.
  • Analysis of recently published clinical trials.

    • Main Results:

    • Splanchnic hypoperfusion is a significant concern in critically ill patients.
    • The HABR may be impaired during endotoxemia and severe reductions in gut blood flow.
    • Currently, no drugs selectively increase total hepato-splanchnic blood flow to a clinically relevant degree.

    Conclusions:

    • Understanding splanchnic vasoregulation is crucial for managing critically ill patients.
    • Further research is needed to develop therapies that can effectively improve hepato-splanchnic blood flow.
    • Clinical trials are essential for evaluating new strategies to address impaired splanchnic perfusion.