Hemodynamics and oxygen transport dynamics during hepatic resection at different central venous pressures in a pig model

作     者：Wan-Yee Lau Eric CH Lai 

作者机构：Department of Hepatic and Biliary Surgery First Affiliated Hospital Guangxi Medical University Faculty of Medicine the Chinese University of Hong Kong Shatin New Territories Hongkong SAR China 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2011年第10卷第5期

页      面：516-520页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：supported by a grant from the GuangxiNatural Science Foundation (GKZ0447066) 

主　　题：hepatectomy hemorrhage central venous pressure tissue oxygenation hemodynamics 

摘      要：BACKGROUND: Although low central venous pressure (CVP) has been used to minimize blood loss during hepatectomy the impact of variations of CVP on the rate of blood loss and on the perfusion of end-organs has not been evaluated This animal study aimed to evaluate the hemodynamics and oxygen transport changes during hepatic resection at different CVP levels. METHODS: Forty-eight anesthetized Bama miniature pigs were divided into 8 groups with CVP during hepatic resection controlled at 0 to 1, 1 to 2, 2 to 3, 3 to 4, 4 to 5, 5 to 6, 6 to 7, and 7 to 8 cmH 2 O. Intergroup comparisons were made for hemodynamic parameters, oxygen transport dynamics, and the rate of blood loss. RESULTS: The rate of blood loss and the hepatic venous pressure during hepatic resection were almost linearly related to the CVP. A significant drop in the mean arterial pressure cardiac output, and cardiac index occurred between CVP ≥2 and 2 cmH 2 O. Oxygen delivery (DO 2 ), oxygen consumption (VO 2 ) and oxygen extraction ratio (ERO 2 ) remained relatively constant between CVPs of 2 to 8 cmH 2 O. There was a significant drop in DO 2 when the CVP was 2 cmH 2 O. There was also a significant drop in VO 2 and ExO 2 when the CVP was 1 cmH 2 ***: The optimal CVP for hepatic resection is 2to 3 cmH2O.