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Vasopressin and nitroglycerin decrease portal and hepatic venous pressure and hepato-splanchnic blood flow.

E Wisén1, K Svennerholm1, L S Bown1

  • 1Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.

Acta Anaesthesiologica Scandinavica
|March 27, 2018
PubMed
Summary
This summary is machine-generated.

The combination of vasopressin and nitroglycerin significantly reduces portal venous pressure and hepato-splanchnic blood flow in patients with normal portal pressure. This finding suggests a potential new method for minimizing blood loss during liver surgery.

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Area of Science:

  • Hepatology
  • Surgical Innovation
  • Hemodynamics

Background:

  • Effective methods to reduce venous blood pressure in the hepato-splanchnic circulation are crucial for minimizing blood loss during liver surgery.
  • Previous research indicated that a combination of vasopressin and nitroglycerin can reduce portal pressure and flow in patients with portal hypertension.
  • This study aimed to investigate the efficacy of this combination in patients with normal portal pressure.

Purpose of the Study:

  • To evaluate the effect of vasopressin and nitroglycerin combination on portal venous pressure (PVP) and hepatic venous pressure (HVP) in patients with normal portal pressure.
  • To assess the impact of this combination on portal and hepato-splanchnic blood flow.
  • To determine the potential of this combined therapy in reducing blood loss during liver resection surgery.

Main Methods:

  • A study involving 13 patients with normal portal pressure.
  • Measurements of PVP, HVP, central hemodynamics, and blood gases were taken at baseline, during vasopressin infusion, and during combined vasopressin and nitroglycerin infusion.
  • Portal and hepato-splanchnic blood flow changes were calculated.

Main Results:

  • Vasopressin alone did not significantly alter PVP but slightly increased HVP.
  • The combination of vasopressin and nitroglycerin significantly decreased both PVP (from 10.1 to 8.9 mmHg) and HVP (from 7.9 to 6.2 mmHg).
  • This combination markedly reduced portal blood flow (by 55%) and hepatic venous flow (by 30%), with a notable decrease in cardiac index.

Conclusions:

  • The combination of vasopressin and nitroglycerin effectively decreases portal pressure and hepato-splanchnic blood flow in patients with normal portal pressure.
  • This therapeutic approach shows promise as a method to reduce intraoperative bleeding during liver resection.
  • Further research may validate this combination as a standard procedure in liver surgery.