Role of the splanchnic bed in extracting circulating adrenaline and noradrenaline in normal subjects and in patients with cirrhosis of the liver

Abstract

Splanchnic extraction rates of adrenaline and noradrenaline were determined in seven normal subjects and in nine patients with cirrhosis of the liver using arterial-hepatic venous catherization . Both catecholamines were effectively removed when the blood passed through the splanchnic area: splanchnic fractional uptake of adrenaline in normal subjects was 90 +/- 3%, and lower for noradrenaline, 68 +/- 4% (P less than 0.001). Net splanchnic extraction rates were higher for noradrenaline (126 +/- 16 ng/min) than for adrenaline (40 +/- 10 ng/min, P less than 0.001), probably due to the higher arterial plasma levels of noradrenaline. Resting arterial adrenaline and noradrenaline levels were significantly higher in cirrhotic patients than in normal subjects (adrenaline: 121 +/- 27 vs 54 +/- 8 pg/ml, P less than 0.05; noradrenaline: 678 +/- 89 vs 251 +/- 26 pg/ml, P less than 0.005). Net splanchnic catecholamine uptake was increased in cirrhotic patients. The results demonstrate that the splanchnic bed in normal and cirrhotic subjects extracts plasma catecholamines efficiently; they suggest that elevated plasma catecholamines in cirrhosis are not the result of impaired splanchnic catecholamine removal.