@article{0114be88aa644c178cf6e4980a42e368,
title = "Peripheral vasopressin for safe and adequate control of portal hypertension during shunt operations",
abstract = "Nine patients with cirrhosis and portal hypertension were given intraoperative vasopressin (40 U/hr) in a continuous peripheral infusion during establishment of a distal splenorenal shunt. In all patients a significant and sustained reduction in portal venous pressure was achieved. As a result, blood loss during dissection and the time required for operation were minimized. The expected vasopressin-induced reduction in cardiac output was limited to a transient decrease at 5 minutes. There were no significant cardiac arrhythmias. These results suggest that vasopressin given through a peripheral vein during shunt operations is safe and facilitates dissection by providing significant and sustained reductions in portal venous pressure.",
author = "Sirinek, {Kenneth R.} and Martin, {Edward W.} and Thomford, {Neil R.}",
note = "Funding Information: Vasopressin has become an important therapeutic tool in the control of acute hemorrhage from the esophagus, stomach, and intestine. It is the most effective agent available for reducing portal vein pressure, and its administration is currently the method of choice for arresting acute hemorrhage from gastroesophageal varices. In addition, numerous reports advocate its use for the management of bleeding in selected cases of gastritis, peptic ulcer, and diverticulosis of the colon. The capacity of vasopressin to reduce portal hypertension during general anesthesia was established by Schwartz et al [I] in 1959. Recently, Nusbaum et al [2] reported their experience with the use of intraoperative vasopressin as an adjunct during portosystemic shunt operations. The drug was administered as a selective infusion in the superior mesenteric artery. Although portal venous pressure was not measured, they found the blood loss was reduced and less time was required for the operation. In the present study, the effect of vasopressin on portal venous pressure, cardiac output, and other hemodynamic parameters was determined during operations to establish distal spleno-renal (Warren) shunts. Because the administration of vasopressin into a systemic vein has obvious advantages and established efficacy, the drug was given in a continuous infusion through a peripheral vein. Fromt he Department of Surgery, The Ohio State University College of Medicine, Columbus, Dhii. This work was supported by a grant from The John A. Hartford Foundation, Inc. Reprint requests should be addressed to Neil R: Thomford, MD, Department of Surgery, University of North Dakota, 501 Columbia Road. Grand Forks. North Dakota 66201. Presented at the Sixteenth Annual Meeting of the Society for Surgery of the Alimentary Tract, San Antonio, Texas, May 20-21, 1975.",
year = "1976",
month = jan,
doi = "10.1016/0002-9610(76)90430-X",
language = "English (US)",
volume = "131",
pages = "103--107",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "1",
}