Significance of changes in blood pressure and pulse rate after percutaneous liver biopsy.

Blood-pressure and pulse-rate changes were evaluated prospectively in 50 patients undergoing uncomplicated liver biopsies and retrospectively in 4 patients who, since 1973, had recognized postbiopsy hemorrhage requiring transfusion. In uncomplicated biopsies a wide range of variations in vital signs was encountered between "baseline" and "before" controls and between controls and postbiopsy measurements. To place the changes in perspective, percentile scales were developed for percent maximum deviation from control for systolic blood pressure, diastolic blood pressure, and pulse rate. Analysis of changes in patients with significant hemorrhage revealed; (1) marked changes in vital signs in the early (2-hr) postbiopsy period; (2) the association of early hypertensive changes with pain followed by later evidence of hemorrhage in two of the four patients; (3) the lesser helpfulness of pulse change (1 of 4 bleeders) as compared to blood pressure change (4 of 4 patients).