Articles: splanchnic-circulation-physiology.
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Mechanical ventilation with positive end expiratory pressure (PEEP) improves oxygenation and treats acute pulmonary failure. However, increased intrathoracic pressure may cause regional blood flow alterations that may contribute to mesenteric ischemia and gastrointestinal failure. We investigated the effects of different PEEP levels on mesenteric leukocyte-endothelial interactions. ⋯ High intrathoracic pressure was harmful to mesenteric microcirculation in the experimental model of rats with normal lungs and stable systemic blood pressure, a finding that may have relevance for complications related to mechanical ventilation.
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The objective of this prospective, observational study was to test the hypothesis that tissue oxygenation in the splanchnic bed compared with tissue oxygenation in the cerebral circulation changes after feeding in preterm neonates who are tolerating full bolus orogastric feeds. ⋯ This study indicates that CSOR and splanchnic TOI, but not brain TOI, increase significantly after feeding in stable preterm infants who are tolerating full orogastric feeds.
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Critical care medicine · Feb 2009
Increased splanchnic oxygen extraction because of routine nursing procedures.
Multiple organ failure is a common complication of acute circulatory and respiratory failure. We hypothesized that therapeutic interventions used routinely in intensive care can interfere with the perfusion of the gut and the liver, and thereby increase the risk of mismatch between oxygen supply and demand. ⋯ Patients are exposed to repeated episodes of impaired splanchnic perfusion during routine nursing procedures. More research is needed to examine the correlation, if any, between nursing procedures and hepatic venous desaturation.
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Organs from the so-called marginal donors have been used with a significant higher risk of primary non function than organs retrieved from the optimal donors. We investigated the early metabolic changes and blood flow redistribution in splanchnic territory in an experimental model that mimics marginal brain-dead (BD) donor. ⋯ Despite severe hypotension induced by sudden increase of intracranial pressure, the systemic and splanchnic blood flows were partially preserved without signs of severe hypoperfusion (i.e. hyperlactatemia). Additionally, the HABF was mostly negatively affected in this model of marginal BD donor. Our data suggest that not only the cardiac output, but the intrinsic hepatic microcirculatory mechanism plays a role in the hepatic blood flow control after BD.
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J. Thorac. Cardiovasc. Surg. · Nov 2008
Carbon dioxide--a complex gas in a complex circulation: its effects on systemic hemodynamics and oxygen transport, cerebral, and splanchnic circulation in neonates after the Norwood procedure.
Carbon dioxide is suggested to increase oxygen delivery after the Norwood procedure. We sought to quantitatively define the effects of stepwise increases in arterial carbon dioxide tension on systemic oxygen transport and cerebral and splanchnic circulation after the Norwood procedure. ⋯ Moderate hypercapnia increases systemic blood flow because of its effect on systemic vascular resistance after the Norwood procedure. The increase in systemic blood flow is primarily a consequence of increased cerebral blood flow that compromises splanchnic circulation. The decrease in oxygen consumption improves oxygen transport, but the increase in catecholamines may be undesirable. Clinical use of carbon dioxide aiming to improve oxygen delivery should be with caution.