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The Splanchnic Circulation pp 153–164Cite as

Augmentation of Splanchnic Blood Flow

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Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 23))

Abstract

Containing around 1.41, or approximately 30% of the adult circulating blood flow at any given time, the splanchnic circulation represents an important blood reservoir in man [1]. In response to low cardiac output states such as those associated with hemorrhage, the celiac, superior and inferior mesenteric, and hepatic circulations are selectively reduced to maintain blood flow to the vital organs [2]. Price et al. reduced the total blood volume of conscious human volunteers by between 15% and 20% and observed preferential depletion of the splanchnic circulation; the viscera losing roughly 40% of their initial volume, compared with only 10% depletion of the central volume [1]. Activation of the renin-angiotensin system in the kidney during hypotension has been largely incriminated in this so-called autotransfusion response[2, 3]. In terms of immediate survival, selective splanchnic vasoconstriction obviously provides a natural mechanism by which severely injured organisms can maintain consciousness in the face of immediate danger. However, as artificial methods of resuscitation and life-support improve chances of survival into the long term, autotransfusion presents certain problems, since prolonged periods of splanchnic ischemia risk damage to the stomach, small and large intestines, liver, gallbladder, and pancreas [2].

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References

  1. Price HL, Deutsch S, Marshall BE, Stephen GW, Behar MG, Neufeld GR (1966) Hemodynamic and metabolic effects of hemorrhage in man, with particular reference to the splanchnic circulation. Circ Res 18:469–474

    PubMed  CAS  Google Scholar 

  2. Reilly PM, Bulkley GB (1993) Vasoactive mediators and splanchnic perfusion. Crit Care Med 21:S55-S68

    Article  PubMed  CAS  Google Scholar 

  3. Xu D, Qi L, Guillory D, Cruz N, Berg R, Deitch EA (1993) Mechanisms of endotoxin- induced intestinal injury in a hyperdynamic model of sepsis. J Trauma 34:676–682

    Article  PubMed  CAS  Google Scholar 

  4. Warrwick M, Lin TM (1975) Action of glucagon and atropine on mucosal blood flow of resting fundic pouches of dogs. Life Sci 17:333–338

    Article  Google Scholar 

  5. Mailman D (1978) Effects of vasoactive intestinal polypeptide on intestinal absorption and blood flow. J Physiol (Lond) 279:121–1326.

    CAS  Google Scholar 

  6. Schuurkes JA, Charbon GA (1978) Motility and hemodynamics of the canine gastrointestinal tract. Stimulation by pentagastrin, cholecystokinin and vasopressin. Arch Int Pharmocodyn Ther 236:214–227

    CAS  Google Scholar 

  7. Fink MP, Cohn SM, Lee PC, Rothschild HR, Deniz YF, Wang H, Fiddian-Green RG (1989) Effect of lipopolysaccharide on intestinal intramucosal hydrogen ion concentration in pigs: evidence of gut ischemia in a normodynamic model of septic shock. Crit Care Med 17:641–646

    Article  PubMed  CAS  Google Scholar 

  8. Fink MP (1993) Adequacy of gut oxygenation in endotoxemia and sepsis. Crit Care Med 21: S4-S8

    Article  PubMed  CAS  Google Scholar 

  9. Hsueh W, Gonzalez-Crussi F, Arroyave JL (1987) Platelet-activating factor: an endogenous mediator for bowel necrosis in endotoxemia. FASEB J 1:403–411

    PubMed  CAS  Google Scholar 

  10. Sun XM, Hsueh W (1988) Bowel necrosis induced by tumor necrosis factor in rats is mediated by platelet-activating factor. J Clin Invest 81:1328–1332

    Article  PubMed  CAS  Google Scholar 

  11. Gonzalez-Crussi F, Hsueh W (1983) Experimental model of ischemic bowel necrosis. The role of platelet-activating factor and endotoxin. Am J Pathol 112:127–131

    PubMed  CAS  Google Scholar 

  12. Mitchell JA, Kohlhaas KL, Sorrentino R, Warner TD, Murad F, Vane JR (1993) Induction by endotoxin of nitric oxide synthase in the rat mesentery: lack of effect on action of vasoconstrictors. Br J Pharmacol 109:265–270

    PubMed  CAS  Google Scholar 

  13. Szabo C, Mitchell JA, Thiemermann C, Vane JR (1993) Nitric oxide-mediated hypor- eactivity to noradrenaline precedes the induction of nitric oxide synthase in endotoxin shock. Br J Pharmacol 108:786–792

    PubMed  CAS  Google Scholar 

  14. Parks DA, Granger DN (1986) Xanthine oxidase: biochemistry distribution and physiology. Acta Physiol Scand 548:97–100

    Google Scholar 

  15. Granger DN, Kvietys PR, Korthuis RJ, Premen AJ (1989) Microcirculation of the intestinal mucosa. In: Rauner BB, Wood JD, Schultz SG (eds) Handbook of physiology; the gastrointestinal system. Oxford University Press, New York, pp 1405–1474

    Google Scholar 

  16. Granger DN, Rutili G, McCord JM (1981) Superoxide radicals in feline intestinal ischemia. Gastroenterology 81:22–29

    PubMed  CAS  Google Scholar 

  17. Scalia S, Sharma P, Rodriguez J, Roche F, Luchette F, Chambers R, Flint LM, Steinberg S (1992) Decreased mesenteric blood flow in experimental multiple organ failure. J Surg Res 52:1–5

    Article  PubMed  CAS  Google Scholar 

  18. Carrico CJ, Meakins JL, Marshall JC, Iry D, Maier RV (1986) Multiple-organ-failure syndrome. Arch Surg 121:196–208

    PubMed  CAS  Google Scholar 

  19. Arvidsson D, Rasmussen I, Almqvist P, Niklasson F, Haglund U (1991) Splanchnic oxygen consumption in septic and hemorrhagic shock. Surgery 109:190–197

    PubMed  CAS  Google Scholar 

  20. Parks DA, Granger DN (1986) Contributions of ischemia and reperfusion to mucosal lesion formation. Am J Physiol 250: G749-G755

    PubMed  CAS  Google Scholar 

  21. Parks DA, Granger DN (1983) Ischemia-induced vascular changes: role of xanthine oxidase and hydroxyl radicals. Am J Physiol 245: G285-G291

    PubMed  CAS  Google Scholar 

  22. Breslow MJ, Miller CF, Parker SD, Walman AT, Traystman RJ (1987) Effect of vasopressors on organ blood flow during endotoxin shock in pigs. Am J Physiol 252:H291-H300

    PubMed  CAS  Google Scholar 

  23. Bersten AD, Hersch M, Cheung H, Rutledge FS, Sibbald WJ (1992) The effect of various sympathomimetics on the regional circulations in hyperdynamic sepsis. Surgery 112:549–561

    PubMed  CAS  Google Scholar 

  24. Meadow WL, Meus PJ (1985) Unsuspected mesenteric hypoperfusion despite apparent hemodynamic recovery in the early phase of septic shock in piglets. Circ Shock 15:123–129

    PubMed  CAS  Google Scholar 

  25. Burlew BS, Gheorghiade M, Jafri SM, Goldberg AD, Goldstein S (1987) Acute and chronic hemodynamic effects of nicardipine hydrochloride in patients with heart failure. Am Heart J 114:793–804

    Article  PubMed  CAS  Google Scholar 

  26. Fink MP, Kaups KL, Wang H, Rothschild HR (1991) Maintenance of superior mesenteric arterial perfusion prevents increased intestinal mucosal permeability in endotoxic pigs. Surgery 110:154–161

    PubMed  CAS  Google Scholar 

  27. Vallet B, Lund N, Curtis SE, Kelly D, Cain SM (1994) Gut and muscle tissue P02 in endotoxemic dogs during shock and resuscitation. J Appl Physiol 76:793–80028.

    PubMed  CAS  Google Scholar 

  28. Nelson DP, Beyer C, Samsel RW, Wood LDH, Schumacker PT (1987) Pathological supply dependence of 02 uptake during bacteremia in dogs. J Appl Physiol 63:1487–1492

    PubMed  CAS  Google Scholar 

  29. Ruokonen E, Takala J, Kari A, Saxen H, Mertsola J, Hansen EJ (1993) Regional blood flow and oxygen transport in septic shock. Crit Care Med 21:1296–1303

    Article  PubMed  CAS  Google Scholar 

  30. Kvietys PR, Granger DN (1982) Relationship between intestinal blood flow and oxygen uptake. Am J Physiol 242: G202-G209

    PubMed  CAS  Google Scholar 

  31. Ottosson J, Dawidson I, Brandberg A, Idvall J, Sandor Z (1991) Cardiac output and organ blood flow in experimental septic shock: the effect of treatment with antibiotics, corticosteroids, and fluid infusion. Circ Shock 35:14–24

    PubMed  CAS  Google Scholar 

  32. Ross G (1967) Effects of epinephrine and norepinephrine on the mesenteric circulation of the cat. Am J Physiol 212:1037–1042

    PubMed  CAS  Google Scholar 

  33. Charbon GA, Reneman RS (1970) The effects of ß-receptor agonists and antagonists on regional blood flow. Eur J Pharmacol 9:21–26

    Article  PubMed  CAS  Google Scholar 

  34. Schneider AJ, Groeneveld AB, Teule GJ, Wesdorp RI, Thijs LG (1991) Total body blood volume redistribution in porcine E. coli septic shock: effect of volume loading, dobutamine and norepinephrine. Circ Shock 35:215–222

    PubMed  CAS  Google Scholar 

  35. Segal JM, Phang T, Walley KR (1992) Low-dose dopamine hastens, onset of gut ischemia in a porcine model of hemorrhagic shock. J Appl Physiol 73:1159–1164

    PubMed  CAS  Google Scholar 

  36. Feltes TF, Hansen TN, Martin CG, Leblanc AL, Smith S, Giesler ME (1987) The effects of dopamine infusion on regional blood flow in newborn lambs. Pediatr Res 21:131–136

    Article  PubMed  CAS  Google Scholar 

  37. Bredle DL, Cain SM (1991) Systemic and muscle oxygen uptake/delivery after dopex- amine infusion in endotoxic dogs. Crit Care Med 19:198–202

    Article  PubMed  CAS  Google Scholar 

  38. Van Lambalgen AA, Van Kraats AA, Van de Vaart-Mulder MF, Van den Bos GC, Stel HV, Straub JP, Doncker AJM, Thijs LG (1991) Systemic and renal actions of dopexamine and dobutamine during endotoxin shock in the rat. J Crit Care 6:61–70

    Article  Google Scholar 

  39. Van Lambalgen AA, Van Kraats AA, Mulder MF, Van den Bos GC, Teerlink T, Thijs LG (1993) Organ blood flow and distribution of cardiac output in dopexamine- or do- butamine-treated endotoxemic rats. J Crit Care 8:117–127

    Article  PubMed  Google Scholar 

  40. Tighe D, Moss R, Haywood G, Webb A, Al-Saady N, Heath F, Bennett D (1993) Dopexamine hydrochloride maintains portal blood flow and attenuates hepatic ultras- tructural changes in a porcine peritonitis model of multiple system organ failure. Circ Shock 39:199–206

    PubMed  CAS  Google Scholar 

  41. Webb AR, Moss RF, Tighe D, Al-Saady N, Bennett ED (1992) The effects of dobutamine, dopexamine and fluid on hepatic histological responses to porcine faecal peritonitis. Intensive Care Med 17:487–193

    Article  Google Scholar 

  42. Cain SM, Curtis SE (1991) Systemic and regional oxygen uptake and delivery and lactate flux in endotoxic dogs infused with dopexamine. Crit Care Med 19:1552–1560

    Article  PubMed  CAS  Google Scholar 

  43. Fink MP, Rothschild R, Deniz YF, Wang H, Lee PC, Cohn SM (1989) Systemic and mesenteric 02 metabolism in endotoxic pigs: effect of ibuprofen and meclofenamate. J Appl Physiol 67:1950–1957

    PubMed  CAS  Google Scholar 

  44. Fink MP, Kaups KL, Wang H, Rothschild HR (1992) Ibuprofen improves survival but does not ameliorate increased gut mucosal permeability in endotoxic pigs. Arch Surg 127:49–54

    PubMed  CAS  Google Scholar 

  45. Nishijima MK, Breslow MJ, Miller CF, Traystman RJ (1988) Effect of naloxone and ibuprofen on organ blood flow during endotoxic shock in pig. Am J Physiol 255:H177-H184

    PubMed  CAS  Google Scholar 

  46. Lefer AM, Tabas J, Smith EF (1980) Salutary effects of prostacyclin in endotoxic shock. Pharmacology 21:206–212

    Article  PubMed  CAS  Google Scholar 

  47. Etemadi AR, Tempel GE, Farah BA, Wise WC, Halushka PV, Cook JA (1987) Beneficial effects of a leukotriene antagonist on endotoxin-induced acute hemodynamic alterations. Circ Shock 22:55–63

    PubMed  CAS  Google Scholar 

  48. Zhang H, Spapen H, Nguyen DN, Rogiers P, Bakker J, Vincent JL (1995) Effects of N-acetyl-l-cysteine on regional blood flow during endotoxic shock. Eur J Surg 9:236- 243

    Google Scholar 

  49. Zhang H, Spapen H, Manikis P, Rogiers P, Metz G, Buurman WA, Vincent JL (1995) Tirilazad mesylate (U74006F) inhibits the effets of endotoxin in dogs. Am J Physiol 268: H1847-H1855

    PubMed  CAS  Google Scholar 

  50. Spain DA, Wilson MA, Bar-Natan MF, Garrison RN (1994) Nitric oxide synthase inhibition aggravates intestinal microvascular vasoconstriction and hypoperfusion of bacteremia. J Trauma 36:720–725

    Article  PubMed  CAS  Google Scholar 

  51. Meyer J, Traber LD, Nelson S, Lentz CW, Nakazawa H, Herndon DN, Nöda H, Traber DL (1992) Reversal of hyperdynamic response to continuous endotoxin administration by inhibition of NO synthesis. J Appl Physiol 73:324–328

    PubMed  CAS  Google Scholar 

  52. Hutcheson IR, Whittle BJR, Boughton-Smith NK (1990) Role of nitric oxide in maintaining vascular integrity in endotoxin-induced acute intestinal damage in the rat. Br J Pharmacol 101:815–820

    PubMed  CAS  Google Scholar 

  53. Zhang H, Rogiers P, Preiser JC, Spapen H, Manikis P, Vincent JL (1995) Effects of methylene blue on oxygen availability and regional blood flow during endotoxic shock. Crit Care Med (in press)

    Google Scholar 

  54. Chang SW, Feddersen CO, Henson PM, Voelkel NF (1987) Platelet-activating factor mediates hemodynamic changes and lung injury in endotoxin-treated rats. J Clin Invest 79:1498–1509

    Article  PubMed  CAS  Google Scholar 

  55. Sun X, Hsueh W (1988) Bowel necrosis induced by tumour necrosis factor in rats is mediated by platelet activating factor. J Clin Invest 81:1328–1331

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. J.-L. Vincent
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  2. D. Schmartz
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  3. D. De Backer
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Editor information

Editors and Affiliations

  1. Dept. of Anesthesiology and Critical Care Medicine, University of Pittsburgh, 604 Scaife Hall, 15261, Pittsburgh, PA, USA

    Michael R. Pinsky

  2. Clinical Pharmacology and Critical Care Medicine, Cochin Port-Royal University Hospital, 27 rue du Faubourg St. Jaques, F-75679, Paris, France

    Jean-Francois Dhainaut

  3. Servei des Medicina Intensiva Parc Tauli, Consorci Hospitalari Parc Tauli, E-08208, Sabadell, Spain

    Antonio Artigas

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© 1995 Springer-Verlag Berlin Heidelberg

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Vincent, JL., Schmartz, D., De Backer, D. (1995). Augmentation of Splanchnic Blood Flow. In: Pinsky, M.R., Dhainaut, JF., Artigas, A. (eds) The Splanchnic Circulation. Update in Intensive Care and Emergency Medicine, vol 23. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79715-6_13

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  • DOI: https://doi.org/10.1007/978-3-642-79715-6_13

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79717-0

  • Online ISBN: 978-3-642-79715-6

  • eBook Packages: Springer Book Archive

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