Is it feasible to monitor total hepatic blood flow by use of transesophageal echography? An experimental study in pigs

Citation
W. Schutz et al., Is it feasible to monitor total hepatic blood flow by use of transesophageal echography? An experimental study in pigs, INTEN CAR M, 27(3), 2001, pp. 580-585
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
INTENSIVE CARE MEDICINE
ISSN journal
0342-4642 → ACNP
Volume
27
Issue
3
Year of publication
2001
Pages
580 - 585
Database
ISI
SICI code
0342-4642(200103)27:3<580:IIFTMT>2.0.ZU;2-5
Abstract
Objectives: Total hepatic venous blood flow is determined by the common hep atic arterial blood flow and the venous outflow from stomach, spleen, pancr eas, small intestine, and bowel, collected by the portal vein, and thus rep resents overall splanchnic perfusion. We investigated whether transesophage al echography (TEE) can provide a method for bedside assessment of hepatic venous blood flow useful as a noninvasive method for measuring splanchnic p erfusion in clinical practice. Design and setting Experimental study in 15 anesthetized and ventilated pig s in an animal research laboratory. Interventions: TEE-derived calculations of hepatic venous blood flow were c ompared with liver blood now measurements using perivascular ultrasound flo w probes surgically positioned on portal vein and common hepatic artery. Pa rameters were determined at baseline and after modulating splanchnic perfus ion by either PEEP maneuver (15 cmH(2)O) or intravenous epinephrine (0.1 mu g kg(-1) min(-1)). Measurements and results: Diameter (d) and velocity time integral (VTI) of ail three hepatic veins were determined by TEE, heart rate (HR) was derived from electrocardiography and flow subsequently calculated as Q = pi (.) (d /2)(2 .) 0.57 (.) VTI HR. Regression analysis of matched TEE and now probe values showed a significant linear relationship (r(2) = 0.698). Bias analys is revealed a systematic underestimation of liver blood flow by TEE, possib ly due to use of 0.57 as correction factor for mean velocity, while changes in liver blood now were reliably detected. Conclusion: TEE offers a noninvasive approach for monitoring hepatic perfus ion and may be used in patients.