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Reduced central blood volume in cirrhosis
J H Henriksen1, F Bendtsen, T I Sørensen
1Department of Clinical Physiology, Hvidovre Hospital, University of Copenhagen, Denmark.
Gastroenterology
|December 1, 1989
Summary
Cirrhosis patients have reduced central blood volume, challenging ascites formation theories. This study developed a new method to measure central blood volume, revealing underfilling in cirrhosis patients.
Area of Science:
- Hepatology
- Cardiology
- Hemodynamics
Background:
- The cause of ascites in cirrhosis remains debated, with underfilling versus overflow theories lacking definitive evidence.
- Previous studies lacked precise methods to measure central blood volume, hindering understanding of circulatory changes in cirrhosis.
Purpose of the Study:
- To develop and apply a novel method for directly measuring central blood volume in patients with cirrhosis.
- To investigate the relationship between central blood volume and ascites formation in cirrhosis.
Main Methods:
- Developed a method to determine central blood volume using kinetic theory (cardiac output × mean transit time).
- Assessed central blood volume in 60 cirrhosis patients and 16 controls.
- Correlated central blood volume with hepatic venous pressure gradient and systemic vascular resistance.
Main Results:
- Central blood volume was significantly lower in cirrhosis patients (21 ml/kg) compared to controls (27 ml/kg).
- Lowest central blood volume observed in patients with severe ascites and reduced systemic vascular resistance.
- Central blood volume inversely correlated with hepatic venous pressure gradient, and total blood volume inversely correlated with systemic vascular resistance.
Conclusions:
- Cirrhosis patients exhibit reduced central blood volume, supporting the central circulatory underfilling concept.
- Potential causes include vasodilation, portosystemic shunting, or ascites fluid sequestration.
- Findings indicate central underfilling is a key aspect of hemodynamic derangement in cirrhosis.
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