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Published in: Critical Care 4/2002

01-08-2002 | Review

Clinical review: Splanchnic ischaemia

Author: Stephan M Jakob

Published in: Critical Care | Issue 4/2002

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Abstract

Inadequate splanchnic perfusion is associated with increased morbidity and mortality, particularly if liver dysfunction coexists. Heart failure, increased intra-abdominal pressure, haemodialysis and the presence of obstructive sleep apnoea are among the multiple clinical conditions that are associated with impaired splanchnic perfusion in critically ill patients. Total liver blood flow is believed to be relatively protected when gut blood flow decreases, because hepatic arterial flow increases when portal venous flow decreases (the hepatic arterial buffer response [HABR]). However, there is evidence that the HABR is diminished or even abolished during endotoxaemia and when gut blood flow becomes very low. Unfortunately, no drugs are yet available that increase total hepato-splanchnic blood flow selectively and to a clinically relevant extent. The present review discusses old and new concepts of splanchnic vasoregulation from both experimental and clinical viewpoints. Recently published trials in this field are discussed.
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Metadata
Title
Clinical review: Splanchnic ischaemia
Author
Stephan M Jakob
Publication date
01-08-2002
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2002
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc1515

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