[Changes in intraoperative total oxygen consumption in patients during liver transplantation].
The changes in O2-uptake (VO2) during 110 liver transplantations (LTX) were studied using Fick's principle (O2-uptake = cardiac index x arteriovenous O2-content difference). During each of the three operative periods [a dissecting period before clamping of the hepatic vessels (1), the anhepatic phase (2), and after reperfusion of the new liver (3)], two measurements (A and B) were taken. After removal of the liver (2A) the VO2 decreased about 11.4%, and increased after reperfusion (3A) about 44.0%; these changes were significant (P less than 0.001). To evaluate the influence of the various indications for LTX on the course of intraoperative VO2, the following patient groups were compared: patients with hepatic tumors (n = 17), patients with cirrhosis following hepatitis (n = 14), patients with primary biliary cirrhosis (n = 17), patients with cirrhosis plus tumor (n = 11), and patients in a hepatic coma (n = 20), regardless of the underlying liver disease. Groups with less than ten subjects were not considered. The drop of VO2 in the anhepatic period (1B----2A) was between -26.7% (patients with tumors) and -7.3% (patients with cirrhosis plus tumor). The patients with cirrhosis following hepatitis showed a special feature: their VO2 increased about 13.4% after cross-clamping the hepatic vessels. After revascularization, the VO2 increased in all groups between +37.2% and +69.8%. In all groups the level of VO2 was higher after reperfusion (3A) than in the dissecting period (1B), ranging from +5.3% in patients with tumors to +61.6% in patients with cirrhosis following hepatitis.(ABSTRACT TRUNCATED AT 250 WORDS)
Lübbe
N
N
Institut für Anaesthesiologie, Abteilung I, Medizinische Hochschule, Hannover.
Bornscheuer
A
A
Grosse
H
H
Ringe
B
B
Gubernatis
G
G
Seitz
W
W
D002759:Adenoma, Bile Duct / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001650:Bile Duct Neoplasms / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D002302:Cardiac Output; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D008107:Liver Diseases / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*
D010100:Oxygen
Veränderungen des intraoperativen Gesamtsauerstoffverbrauchs bei Lebertransplantationen.