Splanchnic vasoregulation during mesenteric ischemia and reperfusion in pigs.
We evaluated the hepatic arterial buffer response (HABR) to portal vein (PV) occlusion during 2 h of reduced superior mesenteric arterial blood flow (median 2 mL min(-1) kg(-1), range of 1-3 mL min(-1) kg(-1)) and 1 h of reperfusion in seven pigs and in seven controls. In animals with reduced mesenteric blood flow, celiac trunk blood flow (Qtr) increased during mesenteric hypoperfusion from 4 +/- 1 mL min(-1) kg(-1) (mean +/- SD) to 16 +/- 3 mL min(-1) kg(-1) (P = 0.028), and hepatic arterial blood flow (Qha) increased from 2 +/- 1 to 10 +/- 4 mL min(-1) kg(-1) (P= 0.018). The extra-hepatic fraction of Qtr (Qtr-Qha) also increased (P = 0.028). In controls, Qtr and Qha also increased, but to lower levels. At baseline, acute PV occlusion increased Qha by 5.0 +/- 2.8 mL min(-1) kg(-1) (P < 0.001), whereas Qtr-Qha decreased by 1.6 +/- 1.6 mL min(-1) kg(-1) (P = 0.007). After 120 min of reduced mesenteric blood flow, the HABR was exhausted (change in Qha to PV occlusion of 0.7 +/- 1.6 mL min(-1) kg(-1) [P= 0.27]). The efficacy of the HABR was also reduced in controls animals. Despite increased cardiac output, all flows from the celiac trunk decreased during reperfusion (P = 0.028) and the HABR partially recovered. We conclude that reduced mesenteric perfusion impairs the HABR, which recovers only partially after reperfusion. The distribution of the increased celiac trunk flow secondary to PV occlusion ranges from increased HABR and decreased non-hepatic blood flow (a steal) to decreased hepatic arterial blood flow and increased non-hepatic blood flow (an inverse steal).
Jakob
Stephan M
SM
Department of Intensive Care Medicine, University Hospital, Bern, Switzerland.
Tenhunen
Jyrki J
JJ
Heino
Autero
A
Pradl
Richard
R
Alhava
Esko
E
Takala
Jukka
J
D000222:Adaptation, Physiological; D000704:Analysis of Variance; D000818:Animals; D001783:Blood Flow Velocity; D001784:Blood Gas Analysis; D002302:Cardiac Output; D004195:Disease Models, Animal; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D007511:Ischemia / Q000503:physiopathology* / Q000628:therapy*; D008102:Liver Circulation / Q000502:physiology*; D008641:Mesenteric Vascular Occlusion / Q000503:physiopathology* / Q000628:therapy*; D008643:Mesentery / Q000098:blood supply*; D011169:Portal Vein / Q000502:physiology; D011336:Probability; D012016:Reference Values; D015424:Reperfusion / Q000379:methods; D012680:Sensitivity and Specificity; D013152:Splanchnic Circulation / Q000502:physiology*; D018709:Statistics, Nonparametric; D013552:Swine