Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of anti-inflammatory corticoids in anesthesia and resuscitation is a long-standing fact, but their indications, owing to the risks to which they expose certain patients and owing to the uncertitude concerning their mechanism of action, are still badly defined. If certain indications (attacks of asthma, laryngeal oedema, certain peri-lesional oedemas) are considered as being categorial, the usefulness of anti-inflammatory corticotherapy is being more and more and more debated in other pathological conditions : infectious or chemical pneumonias, drowning, shocked lung, post-traumatic neuro-surgical conditions, cirrhosis. Very useful in precise indications, anti-inflammatory corticoids should not be prescribed, particularly in fragile patients whom we well know in resuscitation, without having weighed up the advantages and disadvantages related to this remarkable therapeutic instrument.
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PMID:[Indications for anti-inflammatory corticoids in anesthesia-resuscitiation]. 0 87

From 1971-1973, 1046 patients underwent laparoscopy in the gynecological department; 256 of the cases were surgical problems. In contrast to gastroenterological laparoscopy, surgical laparoscopy was performed in the operating room under general anaesthesia and everything prepared for immediate surgery. Major surgical interventions--if necessary--were performed immediately after laparoscopy. Indications for surgical laparoscopy were the following: preoperative evaluation of nature, extent and eventual metastases of tumors. Preoperative differentiation of acute and chronic appendicitis from other affections, particularly in younger female patients. Suspected intraabdominal hemorrhage of traumatic or non-traumatic origin. Evaluation of pathological palpatory findings in the abdominal cavity. Differential diagnosis of chronic relapsing intraabdominal complaints of unknown origin. Differential diagnosis of putrid, tuberculous or carcinomatous peritonitis with eventual biopsy. Preoperative evaluation of questions concerning surgery of liver, gallbladder or pancreas in connection with occlusive jaundice, hepatic cirrhosis or malignancy. The results of this study show, that by laparoscopy in over 50% of the patients, major surgical interventions could be avoided. Contraindications were primarily limited to pulmonal or cardiac insufficiency. The only complication (intestinal perforation), was adequately dealt with under the given operative conditions.
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PMID:["Surgical" laparoscopy indications and value]. 13 Feb 32

In 19 patients with cirrhosis of the liver and portal hypertension, a catheter was inserted into the portal vein using a percutaneous transhepatic technique. The portal pressure was measured during general anaesthesia with and without halothane, and in the awake state. Addition of halothane to the N2O:O2 anaesthesia did not change portal venous pressure, in spite of a significant fall in arterial blood pressure. Portal venous pressure under general anaesthesia with complete muscle relaxation did not differ from the pressure in the resting, awake patient.
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PMID:Influence of general anaesthesia on portal pressure in liver cirrhosis and portal hypertension. 48 82

Plasma concentrations of alphaxalone have been measured during various rates of continuous infusion of Althesin used to supplement nitrous oxide-oxygen anaesthesia in man. There was an approximately linear relationship between the plasma concentration of alphaxalone and the rate of infusion of Althesin. The rate of uptake of alphaxalone into the liver did not appear to be impaired in the presence of the steroid myoneural blocking agent pancuronium, or in patients with hepatic cirrhosis.
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PMID:Plasma concentrations of alphaxalone during continuous infusion of Althesin. 50 92

Investigations were performed in rats with portacaval anastomosis (PCA) in order to measure hepatic hemodynamics and cardiac output (CO) 3, 6, 14 and 28 days after operation under pentobarbitone anesthesia using the flow fraction distribution method (131I-MAA) of CO. The latter was calculated using Vierordt's principle from blood volume (BV) (125RIHSA-dilution method) and ICG-appearance time (ICG-AT) (ear-densitometry). Even 3 days after PCA CO was increased to 38.7 +/- 5.0 (SD) ml/min/100 g b.w. (normal 23.8), due to an increase of BV from 6.3 +/- 1.4 to 7.5 +/- 0.6 ml/100 g b.w. and a decrease of ICG-AT from 3.6 +/- 0.4 to 2.8 +/- 0.5 s. Arterial hepatic flow fraction of CO increased to 8.7 +/- 2.8% (control: 5.5 +/- 2.4%). Changes could be observed up to day 28. Hepatic blood flow per g liver tended to stabilize but was still decreased at day 28: 1.5 +/- 0.6 ml/min/g liver (control: 2.0 +/- 0.3). The typical hemodynamic changes in human liver cirrhosis can be reproduced by PCA alone. They are considered to be compensatory mechanisms for a reduced portal liver blood flow, which are not found to compensate completely.
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PMID:Hepatic blood flow and cardiac output after porta-caval anastomosis in the rat. 76 71

The peritoneovenous shunt of LeVeen can be safely performed under local anesthesia in patients with advanced cirrhosis and ascites. The results of the technique described have proved satisfactory in 25 diuretic resistant ascites in selected patients. The rapid, downhill course of the patient with severe hepatic encephalopathy or coma is probably unchanged by the presence of the valve. Eighteen surviving patients discharged with shunts in place are under continuing study.
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PMID:Peritoneovenous shunting for ascites. 88 64

The clinical features of tuberculous peritonitis in 48 Ethiopian patients are discussed. Thirty per cent of patients were afebrile, three fourths had ascites, and fifteen per cent had palpable abdominal masses, and therefore several had been wrongly diagnosed initially as cirrhosis of the liver or malignancy. Peritoneal biopsy, usually possible with local anaesthesia only, appears to be the most reliable method of proving the diagnosis of tuberculous peritonitis.
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PMID:Tuberculous peritonitis in Ethiopian patients. 100 82

Enterostomal varices have been recognized as a cause of serious recurrent hemorrhage in patients with portal hypertension secondary to cirrhosis. Most often the varices at the mucocutaneous junction are the source of the hemorrhage. Three patients--two with hemorrhages from ileostomies and one with hemorrhages from a colostomy--are presented. Local measures have proved successful in controlling hemorrhages. Occasionally direct pressure alone will prove sufficient; more often the bleeding varix will need ligation. Complete revision of the enterostomy under local anesthesia can effect total disruption of the protal-systemic shunt and temporarily can eliminate local hemorrhage. Surgically created portasystemic shunts may be considered in good risk patients in order to eliminate hemorrhage from the stomal varices. Palliative local measures, however, remain the treatment of choice in the high-risk, cirrhotic patient who is unlikely to survive a major operation.
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PMID:Massive hemorrhage from ileostomy and colostomy stomas due to mucocutaneous varices in patients with coexisting cirrhosis. 124 84

Severe intraoperative bleeding is one of the main problems during liver transplantation. Acquired hemostatic defects, namely primary or secondary hyperfibrinolysis, are considered significant pathogenetic events. Antithrombin III (ATIII), the main physiological serine protease inhibitor, has a critical role in the regulation of hemostasis. 29 patients with post necrotic cirrhosis undergoing liver transplantation were randomized to receive or not ATIII replacement therapy before the induction of anaesthesia and thereafter throughout surgery. Activation of both coagulation and fibrinolysis (increase of thrombin-antithrombin complexes, fibrin and fibrinogen degradation products) were demonstrated in both groups. Blood loss and transfusion requirements were not affected by ATIII administration.
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PMID:Antithrombin III supplementation during orthotopic liver transplantation in cirrhotic patients: a randomized trial. 129 Jan 69

Six patients were given flumazenil (1 mg) during the anhepatic period of liver transplantation. We found higher mean plasma flumazenil concentrations during the anhepatic period than occurred in patients with hepatic cirrhosis. It was only possible to measure plasma flumazenil concentrations in four patients after revascularisation of the donor liver. Of these, elimination half-lives could be calculated in only three patients (normal in one and prolonged in two). In these two patients the elimination half-lives were prolonged to the same extent as in patients with fulminant hepatic failure. The changes during the anhepatic period occur because the liver contributes to the central volume of distribution. After revascularisation of the donor organ the prolonged half-lives indicate that transplanted livers may not recover normal metabolic functions immediately.
Anaesthesia 1992 Oct
PMID:Plasma concentrations of flumazenil during liver transplantation. 144 85


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