Vasopressin plus oxygen vs vasopressin alone in cirrhotic patients with portal-hypertensive gastropathy: effects on gastric mucosal haemodynamics and oxygenation.
The effects of vasopressin plus oxygen and vasopressin alone on gastric mucosal perfusion and oxygenation were studied using reflectance spectrophotometry and laser Doppler velocimetry in 23 cirrhotic patients with portal-hypertensive gastropathy. The measurements were performed under basal conditions and after double-blinded administration of placebo (n = 7), vasopressin (0.3 U/min; n = 8) or vasopressin (0.3 U/min) plus nasal oxygen (4 L/min; n = 8). No significant effects on gastric mucosal haemodynamics and oxygenation were observed after placebo. In contrast, vasopressin and vasopressin plus oxygen induced a similar reduction in haemoglobin content (-26 +/- 2 and -21 +/- 4%, respectively P < 0.01), and laser Doppler signal (-23 +/- 2 and -22 +/- 2%, respectively, P < 0.01). Although each treatment induced a significant reduction in oxygen saturation (-21 +/- 2 and -7 +/- 1%, respectively P < 0.01), the effect was less pronounced in patients receiving the combination than in those receiving vasopressin alone (P < 0.01). These data suggest that vasopressin and vasopressin plus oxygen reduce gastric mucosal hyperaemia and that the oxygen supplement partially protects against gastric mucosal hypoxia during vasopressin infusion in cirrhotic patients with portal-hypertensive gastropathy.
Iwao
T
T
Department of Medicine II, Kurume University School of Medicine, Japan.
Toyonaga
A
A
Shigemori
H
H
Oho
K
K
Sumino
M
M
Sato
M
M
Tanikawa
K
K
D000368:Aged; D000704:Analysis of Variance; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D005753:Gastric Mucosa / Q000098:blood supply* / Q000187:drug effects / Q000378:metabolism; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D017078:Laser-Doppler Flowmetry; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010102:Oxygen Inhalation Therapy; D013053:Spectrophotometry; D013272:Stomach Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014667:Vasopressins / Q000627:therapeutic use*
D014667:Vasopressins; D010100:Oxygen