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Korean J Anesthesiol > Volume 43(6); 2002 > Article
Korean Journal of Anesthesiology 2002;43(6):763-773.
DOI: https://doi.org/10.4097/kjae.2002.43.6.763   
The Effect of Low Dose Nitroglycerin on Hemodynamics and Local Liver Perfusion Following an Occlusion and Reperfusion of the Hepatic Artery and Portal Vein in Experimental Dogs.
Yoon Jeong Choi, Young Ho Jang, Se Ho Yang, Jin Mo Kim, Jae Kyu Cheun, Heui Koo Yoo, Weon Hyun Cho, Dong Seok Cheun
1Department of Anesthesiology, School of Medicine, Keimyung University, Daegu, Korea. kimjin00@dsmc.or.kr
2Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea.
3Department of General Surgery, School of Medicine, Keimyung University, Daegu, Korea.
4Department of Clinical Pathology, School of Medicine, Keimyung University, Daegu, Korea.
Abstract
BACKGROUND
To reduce massive blood loss during a hepatectomy, many anesthesiologists have used the technique of low central venous pressure maintenance by administration of low dose nitroglycerin (NTG) and/or intravenous fluid reduction. However, so far there have been no studies about local liver perfusion (LLP) changes after hepatic artery (HA) or portal vein (PV) reperfusion in patients receiving nitroglycerin administration. In this study, the changes in hemodynamics and LLP following HA and PV reperfusion along with low dose (2micro gram/kg/min) NTG administration in dogs were observed.
METHODS
A total of 20 mongrel dogs were divided into four groups; HA occlusion and reperfusion group (H, n = 5), NTG administration group during the reperfusion on H (H-NTG, n = 5), PV occlusion and reperfusion group (P, n = 5), NTG administration group during the reperfusion on P (P-NTG, n = 5). After femoral and pulmonary arterial catheterization, a midline abdominal incision was made. HA and PV were exposed to clamp and declamp. A thermal diffusion microprobe was inserted in the liver parenchyme to measure LLP.
RESULTS
The PV blood flow was not changed after HA occlusion, but HA blood flow increased after PV occlusion. The LLP decreased after HA and PV occlusion. The LLP recovered to the baseline level in group H-NTG after HA reperfusion, but the LLP was more increased compared to the baseline level in group H. In group P, the LLP did not recover after PV reperfusion, but the LLP in group P-NTG recovered to the baseline level after PV reperfusion.
CONCLUSIONS
In conclusion, it was observed that the LLP recovered to the baseline level by administration of NTG after PV reperfusion. However, the LLP did not increase after HA reperfusion by administration of low dose NTG.
Key Words: Liver blood flow; liver reperfusion; local liver perfusion; nitroglycerin
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