| Anesthesia for hepatic transplantation: cardiovascular and metabolic alterations and their management. | |
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MedLine Citation:
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PMID: 3918479 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We studied the cardiovascular and metabolic changes occurring during orthotopic liver transplantation in nine patients. The operative management of these patients can be divided into an initial dissection phase, an anhepatic phase when the hepatic artery, portal vein, and inferior vena cava are cross-clamped, and the phase after the release of these clamps. On clamping the inferior vena cava, the systolic arterial pressure decreased from 134 +/- 9 to 104 +/- 8 mm Hg, the pulmonary artery pressure decreased from 25 +/- 4 to 17 +/- 4 mm Hg, the mean pulmonary wedge pressure decreased from 11.9 +/- 1.9 to 6.8 +/- 1.2 mm Hg, and cardiac index decreased from 5.3 +/- 0.3 to 2.7 +/- 0.2 L X min-1 X m-2. There were compensatory increases in systemic vascular resistance from 806 +/- 52 to 1448 +/- 109 dyne X cm X sec-5 and in pulmonary vascular resistance from 78 +/- 13 to 122 +/- 25 dyne X cm X sec-5. Removal of these clamps was followed by an initial depression in cardiac output that returned to preclamping values. Profound metabolic alterations were encountered during these phases. Hydrogen ion concentration increased from a mean of 39 +/- 2 to 45 +/- 2 nmol/L during cross-clamping, with a further increase to 55 +/- 3 nmol/L after the initial perfusion of the new liver. Serum potassium levels increased significantly only on release of the clamps, from a mean of 3.8 +/- 0.3 to a peak of 5.3 +/- 0.6 mmol.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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F J Carmichael; M J Lindop; J V Farman |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 64 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 1985 Feb |
Date Detail:
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Created Date: 1985-02-27 Completed Date: 1985-02-27 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 108-16 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesia / methods* Arteriovenous Shunt, Surgical Blood Glucose / metabolism Blood Pressure Carbon Dioxide / blood Cardiac Output Heart Rate Hemodynamics* Humans Hydrogen-Ion Concentration Intraoperative Complications Intraoperative Period Liver Transplantation* Middle Aged Potassium / blood Pulmonary Artery / physiopathology Pulmonary Wedge Pressure Tidal Volume Vascular Resistance |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 124-38-9/Carbon Dioxide; 7440-09-7/Potassium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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