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Portal hypertension in acute liver failure

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Twenty five patients with acute liver failure were measured for hepatic venous pressure gradient as an index of portal pressure during the course of a transjugular liver biopsy. Hepatic venous pressure gradient ranged from 4 to 24.5 mm Hg with a mean of 12.8 (5.3) mm Hg (normal values less than 5 mm Hg). All patients but one had increased portal pressure gradient. Portal hypertension correlated with the degree of architectural distortion of the liver, as suggested by a direct correlation between hepatic venous pressure gradient and the area of reticulin collapse, evaluated by means of a morphometric analysis on Sirius red stained liver slides (r = 0.43, p less than 0.05). Hepatic venous pressure gradient was significantly higher in patients with ascites (15.1 (5) mm Hg, n = 15) or renal failure (14.4 (5.3) mm Hg, n = 16) than in those without (9.3 (3.4) mm Hg and 10.1 (4) mm Hg, respectively; p less than 0.05). Portal hypertension was associated with systemic vasodilation and a hyperkinetic circulatory state, with decreased arterial pressure, and peripheral resistance and increased cardiac output.

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NAVASA, Miquel, GARCÍA PAGÁN, Juan carlos, BOSCH I GENOVER, Jaume, RIERA, J. r., BAÑARES, Rafael, MAS COMAS, Ana m., BRUGUERA I CORTADA, Miquel, RODÉS, J.. Portal hypertension in acute liver failure. _Gut_. 1992. Vol. 33, núm. 965-968. [consulta: 24 de gener de 2026]. ISSN: 0017-5749. [Disponible a: https://hdl.handle.net/2445/18676]

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