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1 Institute for Surgical Research, The National Hospital, University of Oslo, N-0027, and 2 Department of Cardiology, Ullevaal Hospital, 0407 Oslo, Norway
The equilibrium pressure obtained
during simultaneous occlusion of hepatic vascular inflow and outflow
was taken as the reference estimate of hepatic vascular distending
pressure (Phd). Phd at baseline was 1.1 ± 0.2 (mean ± SE) mmHg higher than hepatic vein pressure
(Phv) and 0.7 ± 0.3 mmHg lower than portal vein
pressure (Ppv). Norepinephrine (NE) infusion increased
Phd by 1.5 ± 0.5 mmHg and Ppv by 3.7 ± 0.6 mmHg but did not significantly increase Phv. Hepatic
lobar vein pressure (Phlv) measured by a micromanometer tipped 2-Fr catheter closely resembled Phd both at baseline
and during NE-infusion. Dynamic pressure-volume (PV) curves
were constructed from continuous measurements of Phv and
hepatic blood volume increases (estimated by sonomicrometry) during
brief occlusions of hepatic vascular outflow and compared with static
PV curves constructed from Phd determinations at five
different hepatic volumes. Estimates of hepatic vascular compliance and
changes in unstressed blood volume from the two methods were in close
agreement with hepatic compliance averaging 32 ± 2 ml · mmHg
1 · kg liver
1. NE
infusion reduced unstressed blood volume by 110 ± 38 ml/kg liver
but did not alter compliance. In conclusion, Phlv reflects hepatic distending pressure, and the construction of dynamic PV curves
is a fast and valid method for assessing hepatic compliance and changes
in unstressed blood volume.
regional circulation; compliance; unstressed blood volume; resistance; norepinephrine
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