Hepatosplanchnic circulation in cirrhosis and sepsis

World J Gastroenterol. 2015 Mar 7;21(9):2582-92. doi: 10.3748/wjg.v21.i9.2582.

Abstract

Hepatosplanchnic circulation receives almost half of cardiac output and is essential to physiologic homeostasis. Liver cirrhosis is estimated to affect up to 1% of populations worldwide, including 1.5% to 3.3% of intensive care unit patients. Cirrhosis leads to hepatosplanchnic circulatory abnormalities and end-organ damage. Sepsis and cirrhosis result in similar circulatory changes and resultant multi-organ dysfunction. This review provides an overview of the hepatosplanchnic circulation in the healthy state and in cirrhosis, examines the signaling pathways that may play a role in the physiology of cirrhosis, discusses the physiology common to cirrhosis and sepsis, and reviews important issues in management.

Keywords: Hepatic artery buffer response; Hepatic circulation; Liver cirrhosis; Sepsis; Splanchnic circulation.

Publication types

  • Review

MeSH terms

  • Animals
  • Hemodynamics
  • Hepatic Artery / physiopathology*
  • Humans
  • Liver Circulation*
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / physiopathology*
  • Liver Cirrhosis / therapy
  • Portal Vein / physiopathology*
  • Prognosis
  • Risk Factors
  • Sepsis / epidemiology
  • Sepsis / physiopathology*
  • Sepsis / therapy
  • Splanchnic Circulation*