MECHANISM OF HYPERDYNAMIC SYSTEMIC CIRCULATION IN CIRRHOTIC PATIENTS

Abstract

In this study, the mechanism of hyperdynamic systemic circulation in cirrhotic patients was studied. Ninety one cirrhotics were deviled into two groups, (A) and (B), according to results of KICG; in group A, K is above 0.09min^-1 and in group B, K is below 0.09min^-1. Systemic hemodynamics were studied by inserting a Swan-Ganz catheter and plasma volume, intraoperative portal vein pressure, plasma catecholamine concentration, and plasma glucagon concentration were measured in each patient.
In group B patients the hyperdynamic systemic circulation was more marked than in group A; the more severe the liver damage is, the higher hyperdynamic state was observed. This hyperdynamic change seems to depend mainly on an increase of plasma volume, which significantly correlates with increase of peripheral a-v shunt and increase of portal vein pressure. Plasma catecholamine and glucagon also seems to aggravate the hyperdynamic systemic circulation.