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Titolo:
Loss of physiologic hepatic blood flow control ("hepatic arterial buffer response") during CO2-pneumoperitoneum in the rat
Autore:
Richter, S; Olinger, A; Hildebrandt, U; Menger, MD; Vollmar, B;
Indirizzi:
Univ Saarland, Inst Clin & Expt Surg, D-66421 Homburg, Germany Univ Saarland Homburg Germany D-66421 xpt Surg, D-66421 Homburg, Germany Univ Saarland, Dept Gen Abdominal & Vasc Surg, D-66421 Homburg, Germany Univ Saarland Homburg Germany D-66421 asc Surg, D-66421 Homburg, Germany Univ Saarland, Dept Trauma Hand & Reconstruct Surg, D-66421 Homburg, Germany Univ Saarland Homburg Germany D-66421 uct Surg, D-66421 Homburg, Germany
Titolo Testata:
ANESTHESIA AND ANALGESIA
fascicolo: 4, volume: 93, anno: 2001,
pagine: 872 - 877
SICI:
0003-2999(200110)93:4<872:LOPHBF>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
ELEVATED INTRAABDOMINAL PRESSURE; CARBON-DIOXIDE PNEUMOPERITONEUM; PORTAL VENOUS FLOW; LAPAROSCOPIC CHOLECYSTECTOMY; SPLANCHNIC CIRCULATION; PERITONEAL INSUFFLATION; SURGERY; CO2; PIGS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Vollmar, B Univ Saarland, Inst Clin & Expt Surg, D-66421 Homburg, Germany Univ Saarland Homburg Germany D-66421 -66421 Homburg, Germany
Citazione:
S. Richter et al., "Loss of physiologic hepatic blood flow control ("hepatic arterial buffer response") during CO2-pneumoperitoneum in the rat", ANESTH ANAL, 93(4), 2001, pp. 872-877

Abstract

We analyzed whether a compensatory increase of hepatic arterial (HA) flow,known as the "hepatic arterial buffer response" (HABR), may serve for maintenance of liver blood supply during laparoscopy-associated portal venous (PV) flow reduction. We assessed HA and PV flow, as well as hepatic tissue oxygenation (Po,) during CO2-pneumoperitoneum in anesthetized and mechanically ventilated Sprague-Dawley rats (n = 7). Control animals (n = 7) without pneumoperitoneum, but tourniquet-induced PV flow reduction served to demonstrate physiologic HABR. Although stepwise tourniquet-induced reduction of PV flow to 20% of baseline values led to a significant (P < 0.05) increase of HA flow from 4.3 +/- 0.7 mL/min to 9.9 +/- 1.7 mL/min, stepwise intraabdominal pressure-induced decrease of PV flow was paralleled by a linear reduction of HA flow from 2.4 :+/- 0.3 mL/min to 1.2 +/- 0.5 mL/min at 18 mm Hg intraabdominal pressure. This loss of HABR was sustained during a subsequent 2 h-period of CO2-pneumoperitoneum contrasting the 2 h of maintenance of HABR in controls. Hepatic tissue Po, decreased during the 2 h-period of pressure- and tourniquet-induced PV flow reduction by 35% to 51%, respectively. On tourniquet release, all variables regained baseline values, whereas evacuation of the pneumoperitoneum allowed all variables except hepatic Po-2 to return to baseline, indicating prolonged tissue hypoxia despite restoredtotal liver blood flow in the Laparoscopic group. Concomitantly, increasedliver enzyme activities reflected moderate tissue damage after 2 h of pneumoperitoneum. In conclusion, intraabdominal CO2-insufflation-induced hemodynamic alterations may impair tissue oxygenation and enzyme release, indicating the potential risk for hepatic tissue damage after prolonged periods oflaparoscopic interventions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 00:16:25