Korean J Anesthesiol.  1999 Mar;36(3):431-436. 10.4097/kjae.1999.36.3.431.

Effect of Hepatic Blood Flow Occlusion on Electrolyte and Arterial Blood Gas during Hepatic Resection

• Park TS
• Kim BI
• Park JW
• Park CH
• Roh WS
• Lee SH

• KMID: 2032285
• DOI: http://doi.org/10.4097/kjae.1999.36.3.431

Abstract

BACKGROUND: Temporary occlusion of hepatic blood inflow and vascular exclusion are effective for reduction of intraoperative bleeding which is a major problem during hepatic resection. But it might be suggested that they resulted in hemodynamic, electrolyte and blood gas changes. This study was designed for investigating those changes during liver resection using portal triad clamping and/or right, left or both hepatic vein clamping.
METHODS
Forty one patients, diagnosed as hepatoma and intrahepatic duct stone, were involved in this study. Duration of liver ischemia was 48.7+/-14.8 min. Hemodynamic variables, electrolytes and arterial blood gas were measured before portal triad clamping and at 10, 30 min after clamping, and 10, 30, and 120 min after declamping, and were compared with each other. Bicarbonate was given when its value was below 20 mEq/L.
RESULTS
In the changes of hemodynamics, diastolic blood pressure was decreased significantly at 10 and 30 min after declamping compared with before clamping. In the changes of ABG and electrolytes, pH, bicarbonate and chloride ion were changed significantly at 10 min after clamping compared with before clamping. pH at 10 min after declamping was decreased more associated with increasing anion gap without change of the bicarbonate and increased PaCO2.
CONCLUSION
From these results, hemodynamic changes are not remarkable but metabolic acidosis is occurred from 10 minutes after portal triad clamping and more acidotic change was developed at 10 min after declamping, immediate treatment of metabolic acidosis is needed.

Keyword

Surgery, hepatic, resection, blood flow occlusion; Monitoring, arterial blood gas, electrolyte

MeSH Terms

Acid-Base Equilibrium
Acidosis
Blood Pressure
Carcinoma, Hepatocellular
Constriction
Electrolytes
Hemodynamics
Hemorrhage
Hepatic Veins
Humans
Hydrogen-Ion Concentration
Ischemia
Liver
Electrolytes