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

Park,  Tae Sook; Kim,  Bong Il; Park,  Jin Woong; Park,  Chan Hong; Roh,  Woon Seok; Lee,  Sang Hwa

doi:1999.36.3.431

Clinical Research Article

Korean Journal of Anesthesiology 1999;36(3):431-436.
DOI: https://doi.org/10.4097/kjae.1999.36.3.431

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

Tae Sook Park, Bong Il Kim, Jin Woong Park, Chan Hong Park, Woon Seok Roh, Sang Hwa Lee

¹Department of Anesthesiology, School of Medicine, Catholic University of Taegu Hyosung, Taegu, Korea.
²Kyungbook National University, Taegu, Korea.

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.

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