Skip to main content
SpringerLink
Log in

Effects of Pharmacologic Agents on Splanchnic Blood Flow

  • Chapter
Gut Dysfunction in Critical Illness

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 26))

Abstract

The splanchnic circulation interacts closely with the systemic hemodynamics and participates in the control of blood pressure and volume. Acute reduction of splanchnic blood flow (SBF) and volume in acute hypovolemia helps to defend the perfusion of the brain and the heart [1, 2]. Inadequate splanchnic tissue perfusion may contribute to the development of multiple organ failure (MOF) and increase the risk of death in critically ill patients [3, 4]. In intensive care patients, there is a complex and poorly understood interaction between the splanchnic tissue perfusion, metabolic demands of the tissues, and the inflammatory response.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rowell LB, Detry JMR, Blackmon JR, Wyss C (1972) Importance of the splanchnic vascular bed in human blood pressure regulation. J Appl Physiol 32:213–220

    PubMed  CAS  Google Scholar 

  2. Edouard AR, Degrémont AC, Duranteau J, Pussard E, Berdeaux A, Samii K (1994) Heterogenous regional vascular responses to simulated transient hypovolemia in man. Intensive Care Med 20: 414–420

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  4. Bruns FJ, Fraley DS, Haigh J, et al (1987) Control of organ blood flow. In: Snyder JV, Pinsky MR (eds) Oxygen transport in the critically ill. Year Book Medical Publishers, Inc. Chicago, pp 87–124

    Google Scholar 

  5. Deitch EA (1992) Multiple organ failure. Pathophysiology and potential future therapy. Ann Surg 216: 117–134

    Article  PubMed  CAS  Google Scholar 

  6. Matuschak GM (1994) Liver-lung interactions in critical illness. New Horizons 2: 488–504

    PubMed  CAS  Google Scholar 

  7. Matuschak GM (1995) Oxidative stress and oxygen-dependent cytokine production. In: Vincent JL (ed) Yearbook of intensive care medicine. Springer-Verlag, Germany, pp 413–421

    Google Scholar 

  8. Granger DN, Richardson PDI, Kvietys PR, Mortillaro NA (1980) Intestinal blood flow. Gastroenterology 78: 837–863

    PubMed  CAS  Google Scholar 

  9. Kvietys PR, Granger DN (1982) Vasoactive agents and splanchnic oxygen uptake. Am J Physiol 243: G1–G9

    PubMed  CAS  Google Scholar 

  10. Ruokonen E, Takala J, Kari A, Saxén 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 

  11. Ruokonen E, Takala J, Kari A (1993) Regional blood flow and oxygen transport in low cardiac output syndrome after cardiac surgery. Crit Care Med 21:1304–1311

    Article  PubMed  CAS  Google Scholar 

  12. Uusaro A, Ruokonen E, Takala J (1995) Gastric mucosal pH does not reflect change in splanchnic blood flow after cardiac surgery. Br J Anaesth 74:149–154

    Article  PubMed  CAS  Google Scholar 

  13. Beam AG, Billing B, Sherlock S (1951) The effect of adrenaline and noradrenaline on hepatic blood flow and splanchnic carbohydrate metabolism in man. J Physiol 115: 430–441

    Google Scholar 

  14. Parviainen I, Ruokonen E, Takala J (1995) Dobutamine-induced dissociation between changes in splanchnic blood flow and gastric intramucosal pH after cardiac surgery. Br J Anaesth 74: 277–282

    Article  PubMed  CAS  Google Scholar 

  15. Gutierrez G, Clark C, Brown SD, Price K, Ortiz L, Nelson C (1994) Effect of dobutamine on oxygen consumption and gastric mucosal pH in septic patients. Am J Respir Crit Care Med 150: 324–329

    PubMed  CAS  Google Scholar 

  16. Marik PE, Mohedin M (1994) The contrasting effects of dopamine and norepinephrine on systemic and splanchnic oxygen utilization in hyperdynamic sepsis. JAMA 272: 1354–1357

    Article  PubMed  CAS  Google Scholar 

  17. Leier CV (1988) Regional blood flow responses to vasodilators and inotropes in congestive heart failure. Am J Cardiol 62: 86E-93E

    Article  Google Scholar 

  18. Richardson PDI, Withrington PG (1981) Liver blood flow. Intrinsic and nervous control of liver blood flow. Gastroenterology 81:159–173

    PubMed  CAS  Google Scholar 

  19. Lundgren O, Haglund U (1978) The pathophysiology of the intestinal countercurrent exchanger. Life Sci 23: 1411–1422

    Article  PubMed  CAS  Google Scholar 

  20. Uusaro A, Ruokonen E, Takala J (1995) Estimation of splanchnic blood flow by the Fick principle in man and problems in the use of indocyanine green. Cardiovasc Res 30: 106–112

    PubMed  CAS  Google Scholar 

  21. Gump FE, Price JB Jr, Kinney JM (1970) Blood flow and oxygen consumption in patients with severe burns. Surg Gynecol Obstetr 130: 23–28

    CAS  Google Scholar 

  22. Gump FE, Price JB Jr, Kinney JM (1970) Whole body and splanchnic blood flow and oxygen consumption measurements in patients with intraperitoneal infection. Ann Surg 171: 321–328

    Article  PubMed  CAS  Google Scholar 

  23. Wilmore DW, Goodwin CW, Aulick LH, Powanda MC, Mason AD, Pruitt MD Jr (1980) Effect of injury and infection on visceral metabolism and circulation. Ann Surg 192: 491–500

    Article  PubMed  CAS  Google Scholar 

  24. Aulick LH, Goodwin CW Jr, Becker RA, Wilmore DW (1981) Visceral blood flow following thermal injury. Ann Surg 193: 112–116

    Article  PubMed  CAS  Google Scholar 

  25. Gottlieb ME, Sarfeh IJ, Stratton H, Goldman ML, Newell JC, Shah DM (1983) Hepatic perfusion and splanchnic oxygen consumption in patients postinjury. J Trauma 23: 836–843

    Article  PubMed  CAS  Google Scholar 

  26. Dahn MS, Lange P, Lobdell K, Hans B, Jacobs LA, Mitchell RA (1987) Splanchnic and total body oxygen consumption differences in septic and injured patients. Surgery 101: 69–80

    PubMed  CAS  Google Scholar 

  27. Dahn MS, Lange P, Wilson RF, Jacobs LA, Mitchell RA (1990) Hepatic blood flow and splanchnic oxygen consumption measurements in clinical sepsis. Surgery 107: 295–301

    PubMed  CAS  Google Scholar 

  28. Steffes CP, Dahn MS, Lange MP (1994) Oxygen transport-dependent splanchnic metabolism in the sepsis syndrome. Arch Surg 129: 46–52

    Article  PubMed  CAS  Google Scholar 

  29. Parviainen I, Rantala A, Ruokonen E, Takala J (1995) Failure of enalaprilat to reduce blood pressure in hypertensive cardiac surgery patients. Crit Care Med 23 (Suppl): A140 (Abst)

    Article  Google Scholar 

  30. Uusaro A, Ruokonen E, Takala J (1995) Splanchnic oxygen transport after cardiac surgery: Evidence for inadequate tissue perfusion after stabilization of hemodynamics. Intensive Care Med 22: 26–33

    Article  Google Scholar 

  31. Parviainen I, Ruokonen E, Takala J (1996) Sodium nitroprusside after cardiac surgery: Central and regional hemodynamics. Acta Anaesth Scand (In press)

    Google Scholar 

  32. Nelson DP, Samsel RW, Wood LDH, Schumacker PT (1988) Pathological supply dependence of systemic and intestinal O2 uptake during endotoxemia. J Appl Physiol 64: 2410–2419

    PubMed  CAS  Google Scholar 

  33. Rowell LB, Blackmon JR, Kenny MA, Escourrou P (1984) Splanchnic vasomotor and metabolic adjustments to hypoxia and exercise in humans. Am J Physiol 247: H251–H258

    PubMed  CAS  Google Scholar 

  34. Ayuse T, Brienza J, Revelry P, Boitnott JK, Robotham JL (1995) Role of nitric oxide in porcine liver circulation under normal and endotoxemic conditions. J Appl Physiol 78: 1319–1329

    PubMed  CAS  Google Scholar 

  35. Parker MM, Shelhelmer JH, Bacharach SL, et al (1984) Profound but reversible myocardial depression in patients with septic shock. Ann Intern Med 100:483–490

    PubMed  CAS  Google Scholar 

  36. Darle N, Lim RC Jr (1975) Hepatic arterial and portal venous flows during hemorrhage. Eur Surg Res 7: 259–268

    Article  PubMed  CAS  Google Scholar 

  37. Dalton JM, Gore DC, Makhoul RG, Fisher MR, DeMaria EJ (1995) Decreased splanchnic perfusion measured by duplex ultrasound in humans undergoing small volume hemorrhage. Crit Care Med 23: 491–497

    Article  PubMed  CAS  Google Scholar 

  38. Ruffolo RR Jr, Fondacaro JD, Levitt B, Edwards RM, Kinter LB (1987) Pharmacologic manipulation of regional blood flow. In: Snyder JV, Pinsky MR (eds) Oxygen transport in critically ill. Year Book Medical Publishers, Chicago, pp 450–474

    Google Scholar 

  39. 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: H291–291H300

    Google Scholar 

  40. Giraud GD, MacCannell KL (1984) Decreased nutrient blood flow during dopamine-and epinephrine-induced intestinal vasodilation. J Pharmacol Exp Ther 230:214–220

    PubMed  CAS  Google Scholar 

  41. Shepherd AP, Riedel GL, Maxwell LC, Kiel JW (1984) Selective vasodilators redistribute intestinal blood flow and depress oxygen uptake. Am J Physiol 247: G377–G384

    PubMed  CAS  Google Scholar 

  42. Löllgen H, Drexler H (1990) Use of inotropes in the critical care setting. Crit Care Med 18: S56–S60

    Article  PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  44. Pawlik W, Mailman D, Shanbour LL, Jacobson ED (1976) Dopamine effects on the intestinal circulation. Am Heart J 91: 325–331

    Article  PubMed  CAS  Google Scholar 

  45. Brown RA, Dixon J, Farmer JB, et al (1985) Dopexamine: A novel agonist at peripheral dopamine receptors and β2-adrenoreceptors. Br J Pharmacol 85: 599–608

    PubMed  CAS  Google Scholar 

  46. Webb AR, Moss RF, Tighe D, Al-Saady N, Bennett ED (1991) The effects of dobutamine, dopexamine and fluid on hepatic histological responses to porcine faecal peritonitis. Intensive Care Med 17:487–493

    Article  PubMed  CAS  Google Scholar 

  47. Leier CV, Binkley PF, Carpenter J, Randolph PH, Unverferth DV (1988) Cardiovascular pharmacology of dopexamine in low output congestive heart failure. Am J Cardiol 62: 94–99

    Article  PubMed  CAS  Google Scholar 

  48. Angehrn W, Schmid E, Althaus F, Niedermann K, Rothlin M (1980) Effect of dopamine on hepatosplanchnic blood flow. J Cardiovasc Pharmacol 2: 257–265

    Article  PubMed  CAS  Google Scholar 

  49. Leier CV, Heban PT, Huss P, Bush CA, Lewis RP (1978) Comparative systemic and regional hemodynamic effects of dopamine and dobutamine in patients with cardiomyopathic heart failure. Circulation 58:466–475

    PubMed  CAS  Google Scholar 

  50. Gårdebäck M, Settergren G, Öhqvist G, Tirèn C (1995) Effect of dopexamine on calculated low gastric intramucosal pH following valve replacement. Acta Anaesth Scand 39: 599–604

    Article  PubMed  Google Scholar 

  51. Gutierrez G, Palizas F, Doglio G, et al (1992) Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 339: 195–199

    Article  PubMed  CAS  Google Scholar 

  52. Silverman HJ, Tuma P (1992) Gastric tonometry in patients with sepsis. Effects of dobutamine infusions and packed red blood cell transfusions. Chest 102: 184–188

    CAS  Google Scholar 

  53. Smithies M, Yee TH, Jackson L, Beale R, Bihari D (1994) Protecting the gut and the liver in the critically ill: Effects of dopexamine. Crit Care Med 22: 789–795

    Article  PubMed  CAS  Google Scholar 

  54. Trinder TJ, Lavery GG, Fee JPH, Lowry KG (1995) Correction of splanchnic oxygen deficit in the intensive care unit: Dopexamine and colloid versus placebo. Anaesth Intensive Care 23: 178–182

    PubMed  CAS  Google Scholar 

  55. Norlen K (1988) Central and regional haemodynamics during controlled hypotension produced by adenosine, sodium nitroprusside and nitroglycerin. Br J Anaesth 61: 186–193

    Article  PubMed  CAS  Google Scholar 

  56. Colley PS, Sivarajan M (1984) Regional blood flow in dogs during halothane anesthesia and controlled hypotension produced by nitroprusside or nitroglycerin. Anesth Analg 63: 503–510

    PubMed  CAS  Google Scholar 

  57. Bulkley GB, Oshima A, Bailey RW (1986) Pathophysiology of hepatic ischemia in cardiogenic shock. Am J Surg 151: 87–97

    Article  PubMed  CAS  Google Scholar 

  58. Cullen JJ, Ephgrave KS, Broadhurst KA, Booth B (1994) Captopril decreases stress ulceration without affecting gastric perfusion during canine hemorrhagic shock. J Trauma 37:43–49

    Article  PubMed  CAS  Google Scholar 

  59. Leier CV, Bambach D, Thompson MJ, Gattaneo SM, Goldberg RJ, Unverferth DV (1981) Central and regional effects of intravenous isosorbide dinitrate, nitroglycerin and nitroprusside in patients with congestive heart failure. Am J Cardiol 48: 1115–1123

    Article  PubMed  CAS  Google Scholar 

  60. Radermacher P, Buhl R, Santak B, et al (1995) The effects of prostacyclin on gastric intramucosal pH in patients with septic shock. Intensive Care Med 21: 414–421

    Article  PubMed  CAS  Google Scholar 

  61. Ensinger H, Weichel T, Lindner KH, Grünert A, Georgieff M (1995) Are the effects of noradrenaline, adrenaline and dopamine infusions on VO2 and metabolism transient? Intensive Care Med 21: 50–56

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. J. Takala
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Surgery, Pennsylvania University Hospital, 3400 Spruce Street, 19104, Philadelphia, PA, USA

    J. L. Rombeau

  2. Department of Intensive Care Critical Care Research Program, Kuopio University Hospital, FIN-70211, Kuopio, Finland

    J. Takala

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Takala, J. (1996). Effects of Pharmacologic Agents on Splanchnic Blood Flow. In: Rombeau, J.L., Takala, J. (eds) Gut Dysfunction in Critical Illness. Update in Intensive Care and Emergency Medicine, vol 26. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80224-9_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-80224-9_18

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-80226-3

  • Online ISBN: 978-3-642-80224-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation