Arterial blood ketone body ratio and systemic hemodynamics in patients with acute hepatic blood flow occlusion
Nakagawa, I.; Izumi, H.; Fujii, K.; Kurokawa, H.; Shiroyama, K.; Kusunoki, K.
Masui. Japanese Journal of Anesthesiology 42(3): 382-386
1993
ISSN/ISBN: 0021-4892 PMID: 8468780 Document Number: 410176
This study was undertaken in order to clarify the influence of acute hepatic blood flow occlusion on arterial blood ketone body ratio (AKBR) and systemic hemodynamics. Ten patients for hepatectomy were divided into two groups. Group I was composed of five patients who had clamping of total hepatic blood flow (Pringle's method), and Group II was composed also of five patients who had clamping of the right hepatic artery and portal vein during operation. Ten minutes after clamping blood flow, AKBR decreased significantly in both groups, and a marked reduction in AKBR was observed in group I. During occlusion, cardiac output was reduced significantly, and immediately after declamping, mean arterial blood pressure and systemic vascular resistance index (SVRI) decreased significantly. These changes in hemodynamics in group I were larger than those of the other group. A larger reduction in AKBR was observed during occlusion, and the greater change in SVRI appeared after declamping blood flow. These findings suggest that in the cases with hepatic blood flow occlusion, especially total occlusion, a special attention should be paid to mitochondrial liver dysfunction and hemodynamic changes associated with acute hepatic blood occlusion.