Nitroglycerin for portal hypertension: A controlled comparison of the hemodynamic effects of graded doses

摘要: Nitroglycerin is reportedly an effective treatment for portal hypertension. However, the effects of graded doses have not been examined. We administered nitroglycerin intravenously to 10 patients with alcoholic cirrhosis, beginning at micrograms/min and doubling dose every min thereafter until mean arterial pressure fell 10-15 mmHg. compared response that receiving a control infusion. The median infusion rate was 40 (range 10-160 micrograms/min). significantly reduced cardiac output as well pulmonary artery, capillary pressure. overall on hepatic venous gradient azygous (gastroesophageal collateral) blood flow were heterogeneous. increased in nitroglycerin-treated high pressures (greater than or equal 12 mmHg) similar filling both maximum rates therefore uniformly Cardiac may be determinant splanchnic hemodynamic nitroglycerin.