{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T19:10:19Z","timestamp":1695496219821},"reference-count":34,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T00:00:00Z","timestamp":1308268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background: <\/jats:bold> Intra\u2010abdominal hypertension (IAH) and abdominal compartment syndrome commonly occur in patients with liver disease.<\/jats:p><jats:p><jats:bold>Aims: <\/jats:bold> We compared haemodynamic variables pre\u2010 and post\u2010abdominal decompression in patients with acute Budd\u2013Chiari syndrome (BCS) and patients with chronic liver disease (CLD), ascites and IAH.<\/jats:p><jats:p><jats:bold>Methods: <\/jats:bold> Patients with IAH admitted to the Liver ICU, King's College Hospital were studied. Transpulmonary thermodilution cardiac output (CO) monitoring was performed with the PiCCO<jats:sup>\u00ae<\/jats:sup> system.<\/jats:p><jats:p><jats:bold>Results: <\/jats:bold> Ten patients with decompensated BCS (median age 39 years, 20\u201352) and eight patients with CLD (59 years, 33\u201365) and tense ascites requiring paracentesis were studied. Intra\u2010abdominal pressure (IAP) was raised in both groups pre\u2010intervention (BSC 23\u2003mmHg, 17\u201340; CLD 26, 20\u201340). Intrathoracic blood volume (ITBVI) was persistently low in the BCS group (632\u2003ml\/m<jats:sup>2<\/jats:sup>, 453\u2013924) despite volume resuscitation. Post\u2010intervention, reduction in IAP was noted in both groups (BCS <jats:italic>P<\/jats:italic>&lt;0.001, CLD <jats:italic>P<\/jats:italic>&lt;0.0001). The ITBVI increased (<jats:italic>P<\/jats:italic>=0.001) in the BCS group only. An increase in cardiac index (CI) and stroke volume index (SVI) was noted in both groups (BCS: CI <jats:italic>P<\/jats:italic>=0.003, SVI: <jats:italic>P<\/jats:italic>=0.007; CLD: CI <jats:italic>P<\/jats:italic>=0.005, SVI <jats:italic>P<\/jats:italic>=0.02). The central venous pressure did not change in either group and did not correlate with markers of flow (CI, SVI) or IAP. Both groups demonstrated an inverse relationship between IAP, CI and SVI.<\/jats:p><jats:p><jats:bold>Conclusion: <\/jats:bold> Patients with BCS and IAH have evidence of central hypovolaemia. In addition to raised IAP, hepatic venous obstruction and caudate lobe hypertrophy limit venous return in patients with BCS. Reduction in IAP and re\u2010establishment of caval flow restores preload with improvement in CO.<\/jats:p>","DOI":"10.1111\/j.1478-3231.2011.02557.x","type":"journal-article","created":{"date-parts":[[2011,6,18]],"date-time":"2011-06-18T00:51:32Z","timestamp":1308358292000},"page":"1171-1178","source":"Crossref","is-referenced-by-count":2,"title":["Haemodynamic response to abdominal decompression in acute Budd\u2013Chiari 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