| Autor: |
Katsuramaki, Tadashi, Hirata, Koichi, Mukaiya, Mitsuhiro, Tsuruma, Tetsuhiro, Matsuno, Takashi, Tarumi, Kenn, Yamashiro, Kazuhiro, Oikawa, Ikuo, Denno, Ryuichi |
| Zdroj: |
Journal of Hepato -- Biliary -- Pancreatic Surgery; Sep1997, Vol. 4 Issue 3, p351-355, 5p |
| Abstrakt: |
Hepatic venous oxygen saturation (ShvO2) is an indicator of the hepatic oxygen supply-to-demand ratio, which can be used to estimate adequate hepatic blood flow if hepatic oxygen is constant. We monitored ShvO2 intraoperatively and postoperatively in a patient who underwent right hepatic lobectomy. Decreases in ShvO2 were noted during surgical maneuvers which included manipulation of the hepatic hilum and mobilization of the liver. The ShvO2 recovered immediately after termination of these procedures. After the operation the patient developed hypovolemic shock due to postoperative bleeding; blood pressure dropped from 120 to 90 mmHg and the ShvO2 fell from 70% to 30%. Dopamine (5μg/kg per min) was administered to maintain the blood pressure. Temporary cessation of the dopamine infusion caused a decrease in ShvO2 (from 85% to 75%) without a major change in blood pressure. Dopamine increases hepatic blood flow, and accordingly, this decrease in ShvO2 must have been caused by cessation of the dopamine infusion. This finding suggests that ShvO2 can be used to determine optimal dopamine dosage for maintaining hepatic blood flow. From these observations, ShvO2 accurately reflects changes in hepatic blood flow and ShvO2 monitoring was helpful in avoiding hepatic ischemia during the periperative period in a patient undergoing a hepatectomy. Unexpected changes in hepatic blood flow can be immediately identified by monitoring ShvO2, enabling more rapid intervention. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
Full text from SpringerLink