The Splanchnic Circulation: No Longer A Silent Partner (update In Intensive Care And Emergency Medicine)

This compendium offers the reader a single source from which to review or reference the field of splanchnic circulation in the critically ill, focusing on its role of defining gut and hepatic function, and remote organ interactions. Clinically relevant outcome studies of novel and evolving diagnostic and therapeutic options are presented, and all chapters adopt a pathophysiologic approach and a futuristic format to pick out specific topics from the overall theme of splanchnic blood flow. This monograph focuses on splanchnic function in health and disease. It represents a distillate of the communication that took place at the First International Symposium of Applied Physiol­ ogy of the Peripheral Circulation,'Splanchnic Circulation: No Longer a Silent Partner.'The individual chapters roughly follow the individual presentations and display in durable form the con­ cepts and importance that this symposium achieved. The concept for this annual symposium was the child of An­ tonio Artigas, who not only recruited sponsorship but also Jean­ Francois Dhainaut and me to help with the organization and work. We chose the splanchnic circulation as the peripheral cir­ culatory system to be presented first for many important reasons. Much new information has become available which demon­ strates, as the title of the symposium implies, that splanchnic function has major influence on the overall expression of health and disease in humans. All aspects of splanchnic physiology, it seems, have been rediscovered to be dynamic, important, and complex in their interactions within individual tissues and among remote tissues and organs. It is hoped that after having reviewed this monograph the reader will agree that the splanchnic circula­ tion and its organ systems are emerging as important aspects of critical illness and host-defense homeostasis. Front Matter....Pages I-XI Regional Blood Flow Distribution....Pages 1-13 Gut Metabolism and Anion Flux....Pages 14-26 The Splanchnic Microcirculation: Cytokines and Cell Adhesion Molecules....Pages 27-38 Effects of N -Acetyl-Cysteine on Splanchnic Circulation....Pages 39-43 Hepatic Acute-Phase Response....Pages 44-58 Effects of Catecholamines on Hepatic Blood Flow: Tissue Oxygenation....Pages 59-72 Liver-Lung Interactions in Critical Illness....Pages 73-93 Lung-Liver Interface....Pages 94-99 Regional Monitoring of Gut Mucosal Viability....Pages 100-112 Gastric Intramucosal pH Determination: Limitations of the Technique....Pages 113-127 Gut Permeability....Pages 128-144 Serum Lactate: Marker of Prognosis, Not Inadequacy of Oxygen Delivery....Pages 145-152 Augmentation of Splanchnic Blood Flow....Pages 153-164 Selective Decontamination of the Digestive Tract....Pages 165-174 Effect of Aspirin on Central and Peripheral Cardiovascular Adaptation to Exercise in Heart Failure: Participation of Splanchnic Flow....Pages 175-190 Resuscitation of Trauma Patients....Pages 191-197 Back Matter....Pages 199-203 This compendium offers the reader a single source from which to review or reference the field of splanchnic circulation in the critically ill, focusing on its role of defining gut and hepatic function, and remote organ interactions. Clinically relevant outcome studies of novel and evolving diagnostic and therapeutic options are presented, and all chapters adopt a pathophysiologic approach and futuristic format to pick out specific topics from the overall theme of splanchnic blood flow.

The book contains black-and-white illustrations.