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.

Klappentext

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.

Inhalt

Regional Blood Flow Distribution.- Gut Metabolism and Anion Flux.- The Splanchnic Microcirculation: Cytokines and Cell Adhesion Molecules.- Effects of N-Acetyl-Cysteine on Splanchnic Circulation.- Hepatic Acute-Phase Response.- Effects of Catecholamines on Hepatic Blood Flow: Tissue Oxygenation.- Liver-Lung Interactions in Critical Illness.- Lung-Liver Interface.- Regional Monitoring of Gut Mucosal Viability.- Gastric Intramucosal pH Determination: Limitations of the Technique.- Gut Permeability.- Serum Lactate: Marker of Prognosis, Not Inadequacy of Oxygen Delivery.- Augmentation of Splanchnic Blood Flow.- Selective Decontamination of the Digestive Tract.- Effect of Aspirin on Central and Peripheral Cardiovascular Adaption to Exercise in Heart Failure: Participation of Splanchnic Flow.- Resuscitation of Trauma Patients.