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1 Department of Anesthesiology and Critical Care Medicine, University of Freiburg, D-79106 Freiburg; and 2 Department of Anesthesiology and Critical Care Medicine, University of the Saarland, D-66421 Homburg, Germany
To test whether
hemorrhagic shock and resuscitation (HSR) alters the vascular
responsiveness of the portohepatic circulation to endothelins (ETs), we
studied the macro- and microcirculatory effects of the preferential
ETA receptor agonist ET-1 and of the selective
ETB receptor agonist sarafotoxin 6c (S6c) after 1 h of
hemorrhagic hypotension and 5 h of volume resuscitation in the
isolated perfused rat liver ex vivo using portal pressure-flow relationships and epifluorescence microscopy. Although HSR did not
cause major disturbances of hepatic perfusion per se, the response to
ET-1 (0.5 × 10
9 M) was enhanced, leading to greater
increases in portal driving pressure, total portal resistance, and
zero-flow pressures and more pronounced decreases in portal flow,
sinusoidal diameters, and hepatic oxygen delivery compared with
time-matched sham shock controls. In sharp contrast, the constrictive
response to S6c (0.25 × 10
9 M) remained unchanged.
Thus HSR primes the portohepatic circulation for the vasoconstrictive
effects of ET-1 but does not alter the effects of the ETB
receptor agonist S6c. The enhanced sinusoidal response may contribute
to the subsequent development of hepatic microcirculatory failure after
secondary insults that are associated with increased generation of
ET-1.
endothelin receptors; microcirculation; portal vein; pressure-flow relationship; sarafotoxin 6c
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