Brief Article
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World J Gastroenterol. Feb 14, 2013; 19(6): 882-888
Published online Feb 14, 2013. doi: 10.3748/wjg.v19.i6.882
Chronic intestinal ischemia and splanchnic blood-flow: Reference values and correlation with body-composition
Helle Damgaard Zacho, Jens Henrik Henriksen, Jan Abrahamsen
Helle Damgaard Zacho, Jan Abrahamsen, Department of Clinical Physiology, Viborg Regional Hospital, 8800 Viborg, Denmark
Jens Henrik Henriksen, Department of Clinical Physiology, Hvidovre Hospital, University of Copenhagen, 2650 Hvidovre, Denmark
Author contributions: Zacho HD designed and performed the experiments, analysed data, wrote the manuscript and has approved of the final draft submitted; Henriksen JH analyzed data, edited the manuscript, and has approved of the final draft submitted; Abrahamsen J designed and performed the experiments, supervised the analysis of data, edited the manuscript, and has approved of the final draft submitted; all authors discussed the results and implications and commented on the manuscript at all stages.
Supported by The Rosa and Asta Jensen Foundation; the Danielsen Foundation and the Region Midts Research Foundation
Correspondence to: Dr. Helle Damgaard Zacho, Department of Clinical Physiology, Viborg Regional Hospital, Heibergs Allé 4, 8800 Viborg, Denmark. helle.damgaard@viborg.rm.dk
Telephone: +45-78-443306 Fax: +45-78-443399
Received: July 25, 2012
Revised: November 5, 2012
Accepted: November 24, 2012
Published online: February 14, 2013
Processing time: 207 Days and 15.9 Hours
Abstract

AIM: To determine the splanchnic blood flow and oxygen uptake in healthy-subjects and patients and to relate the findings to body-composition.

METHODS: The total splanchnic blood flow (SBF) and oxygen uptake (SO2U) were measured in 20 healthy volunteers (10 women) and 29 patients with suspected chronic intestinal ischemia (15 women), age 40-85 years, prior to and after a standard meal. The method is based on the Fick principle using the continuous infusion of an indicator (99mTechnetium-labelled mebrofenin) and catheterization of an artery and the hepatic vein. An angiography of the intestinal arteries was performed during the same investigation. A whole-body dual-energy x-ray absorptiometry scan was performed in healthy volunteers to determine body composition.

RESULTS: Angiography revealed no atherosclerotic lesions in the intestinal arteries. The mean baseline SBF was 1087 mL/min (731-1390), and this value increased significantly to 1787 mL/min after the meal in healthy volunteers (P < 0.001). The baseline SBF in patients was 1080 mL/min, which increased to 1718 mL/min postprandially (P < 0.001). The baseline SBF was independent of age, sex, lean body mass and percentage of body fat. The mean meal-induced increase in SBF was equal to 282 mL/min + 5.4 mL/min × bodyweight, (P = 0.025). The SO2U in healthy volunteers and patients was 50.7 mL/min and 48.0 mL/min, respectively, and these values increased to 77.5 mL/min and 75 mL/min postprandially, respectively. Both baseline and postprandial SO2U were directly related to lean body mass. Age and sex exerted no impact on SO2U.

CONCLUSION: A direct correlation between body weight and the postprandial increase in SBF was observed. The effect of body weight should be considered in the diagnosis of chronic intestinal ischemia.

Keywords: Splanchnic circulation; Postprandial period; Body composition; Mesenteric vascular occlusion; Middle aged