Splanchnic haemodynamics after intravenous terlipressin in anaesthetised healthy pigs

Background/Aims: Terlipressin is used for the treatment of bleeding oesopha geal varices, We evaluated the effects of terlipressin on hepatic haemodyna mics, with special focus on the interactions between portal venous flow and hepatic arterial flow over time. Secondly, we evaluated the estimated hepa tic blood bow by the ICG clearance method against direct measurements of he patic blood flow. Methods: Eight healthy anaesthetised pigs received terlipressin 1 mg or pla cebo intravenously in a randomised, blind, cross-over design. Hepatic arter ial flow portal venous flow, systemic haemodynamics, and portal vein diamet er were recorded simultaneously. Portal venous flow and hepatic arterial fl ow were measured by transit time ultrasound flowmetry. Estimated hepatic bl ood flows at baseline and after terlipressin were compared with the sum of the portal venous flow and hepatic arterial flow. Results: Portal venous flow decreased significantly 5 min after administrat ion of terlipressin (p<0.05). At 30 min it had decreased by 34% (p<0.01) an d the hepatic arterial bow had increased by 81% (p<0.01). The estimated hep atic blood flow and the hepatic blood flow decreased by 23% (p<0.015). At b aseline the estimated hepatic blood flow and the hepatic blood flow correla ted significantly (r=0.85, p<0.01), but this correlation disappeared after administration of terlipressin (r=0.06, p=ns). The hepatic blood flow was 1 2% higher than the estimated hepatic blood flow before and after terlipress in. Conclusions: Terlipressin decreased the portal venous flow hepatic blood fl ow, and estimated hepatic blood flow significantly and was accompanied by a substantial increase in hepatic arterial flow The estimated hepatic blood flow and hepatic blood flow were strongly correlated at baseline, but after terlipressin the correlation disappeared.