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Changes in prostaglandin and nitric oxide levels in the hyperdynamic circulation following liver resection
Author(s) -
Lai Oi Fah,
Chow Pierce Kh,
Tan Sally,
Song In Chin,
Soo Khee Chee,
Aw Swee Eng,
Yu Wing Kwong,
FookChong Stephanie Mc,
Satchithanantham Somanesan,
Chan Steven Tf
Publication year - 2000
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2000.02295.x
Subject(s) - hyperdynamic circulation , medicine , hepatectomy , portal venous pressure , portal hypertension , nitric oxide , cardiac output , hemodynamics , blood flow , endocrinology , cirrhosis , surgery , resection
Background and Aims: Significant changes in hepatic haemodynamics occur after major hepatectomy, but the pathogenesis of this phenomenon is unclear. This study investigates the serum profile of prostaglandin and nitric oxide in the hepatic and systemic circulation before and after hepatectomy and the temporal relationship of these to changes in the hepatic blood flow.Methods: Blood samples were collected from the internal jugular, portal and hepatic veins of six Yorkshire pigs (17–25 kg) before, immediately after and 48 h after partial hepatectomy.Results: Serum levels of prostacyclin I 2 (PGI 2 ) and prostaglandin E 2 (PGE 2 ) from the systemic circulation, the portal circulation and from the hepatic veins were found to differ considerably even before hepatectomy. After the hepatectomy was performed, there was a significant rise in PGI 2 levels in the systemic circulation ( P = 0.027). Hepatic blood flow and cardiac output were measured before hepatectomy, 24 and 48 h after hepatectomy in another six pigs. A significant increase in hepatic blood flow ( P = 0.029) occurred after the hepatectomy and this was accompanied by a concomitant increase in the cardiac output ( P = 0.042). The increase in PGI 2 concentration in the systemic circulation after hepatectomy appears to accompany the development of hyperdynamic hepatic and systemic circulations. No significant change was found in circulating PGE 2 levels in the systemic, portal and hepatic veins at the three collection intervals (i.e. pre, post and 48 h after hepatectomy). The PGE 2 levels in the hepatic vein, however, were significantly higher from than in the portal vein ( P = 0.028). No significant changes were observed in the level of nitric oxide.Conclusion: This study demonstrates an increase in the total hepatic blood flow after hepatectomy together with a threefold increase in prostacyclin in the systemic circulation. The liver was identified as the main source of circulatory prostaglandin.