The Splanchnic and Systemic Circulation in Liver Disease

  • Nina T. Yoh
  • Gebhard Wagener


Alterations of the splanchnic circulation are a central component of the pathophysiology of liver disease and result in profound changes of the systemic circulation and ensuing extrahepatic organ damage. An understanding of the changes of the splanchnic and systemic circulation in liver disease is important for the anesthesiologist and critical care physician as anesthetic agents and surgery or other insults such as infections can further exacerbate these changes and cause deterioration of the clinical status of patients.


The splanchnic vascular bed consists of the celiac artery and superior and inferior mesenteric arteries supplying oxygenated blood to abdominal organs. The liver obtains oxygenated blood directly from the hepatic artery that derives from the celiac artery. The other branches of the celiac artery and of the superior and inferior mesenteric artery supply the intestines and the spleen with oxygenated blood (Fig. 4.1). Venous drainage of the...


Liver blood flow Portal hypertension Portal flow Hepatic artery buffer response Splanchnic steal Vasoplegia 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Columbia University Medical CenterNew YorkUSA
  2. 2.Department of AnesthesiologyColumbia University Medical CenterNew YorkUSA

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