Influences of Cardiopulmonary Bypass and Fentanyl Anesthesia on Hepatic Circulation and Oxygen Metabolism in Beagles

Koizumi, Miiko; Matsumoto, Nobuyuki; Ueda, Keisuke

doi:10.1097/00000539-199806000-00007

Cited by 3 publications

(8 citation statements)

References 15 publications

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“…The present study showed that a reduced ShvO 2 occurred during CPB. This is consistent with the results of Koizumi and his colleagues [4]. A possible explanation for the discrepancy between the reports of Haisjackl and his colleagues and Mollhoff and his colleagues might be the differences in the kind of anaesthesia, mean arterial pressure during CPB, or pump¯ow rate.…”

Section: Discussionsupporting

confidence: 90%

“…Mollhoff and his colleagues [11] also reported that hepatic venous oxygen saturation did not change signi®cantly during normothermic CPB in human beings during fentanyl anaesthesia. In contrast, Koizumi and his colleagues [4] reported that total hepatic blood¯ow in dog was decreased during hypothermic CPB due to the 34% decline in portal blood¯ow during fentanyl (50 lg kg ±1 ) anaesthesia. They also observed that hepatic venous oxygen content decreased during CPB compared with pre-CPB.…”

Section: Discussionmentioning

confidence: 89%

“…In contrast, Wouters and his colleagues [13] reported that hepatic arterial¯ow velocity increased after propofol anaesthesia. Koizumi and his colleagues [4] reported that total hepatic blood¯ow was altered by the increment of fentanyl dosage. The drugs and doses used for anaesthesia, e.g.…”

Section: Discussionmentioning

confidence: 99%

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Disturbances in hepatocellular function during cardiopulmonary bypass using propofol anaesthesia

Okano

Fujita

Kikuchi

et al. 2001

European Journal of Anaesthesiology

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Background and objective Serum hyaluronate is thought to be an indicator of derangement in hepatocellular integrity, and the change in serum hyaluronate is a useful indicator in various liver disorders. We assessed the changes in serum hyaluronate in patients undergoing coronary artery bypass graft surgery. Methods Eleven patients scheduled for elective coronary artery bypass graft surgery were studied. An oximetry oxygen saturation catheter was inserted into the right hepatic vein to permit monitoring of hepatic venous oxygen saturation. Perioperative measurements included: haemodynamic variables; systemic oxygen delivery and uptake; arterial, mixed venous and hepatic venous oxygen saturation; arterial and hepatic venous plasma concentrations of lactate, arterial ketone body ratio (ratio of acetoacetate to 3-hydroxybutyrate); and arterial and hepatic venous hyaluronate were measured. Results Arterial and hepatic venous hyaluronate increased during cardiopulmonary bypass compared with the prebypass period. These increases returned to prebypass values after the cessation of bypass (hepatic venous hyaluronate value at the prebypass period: 26 13 ng mL ±1 , during bypass: 77 40 ng mL ±1 ; 1 h after bypass: 57 42 ng mL ±1 ; 6 h after bypass: 32 15 ng L ±1 , 24 h after bypass; 62 21 ng mL ±1 ; mean SD, P < 0.05). The arterial and hepatic venous hyaluronate during cardiopulmonary bypass was correlated with total bilirubin and hepatic venous lactate concentrations 6 h after bypass (arterial hyaluronate at cardiopulmonary bypass period vs. total bilirubin at 6 h after bypass; r 0.793, P 0.0036, hepatic venous hyaluronate during bypass vs. that at 6 h after bypass; r 0.795, P 0.0035). Conclusions Hepatocellular integrity might be disturbed during cardiopulmonary bypass when propofol anaesthesia is used.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 89%

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Disturbances in hepatocellular function during cardiopulmonary bypass using propofol anaesthesia

Okano

Fujita

Kikuchi

et al. 2001

European Journal of Anaesthesiology

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“…It is controversial whether hepatic oxygenation during CPB remains intact or not [3–6,11]. Haisjackl and his colleagues [5] reported that hepatic blood flow during CPB, estimated by constantly infused indocyanine green, was not different from that at pre‐CPB, and that hepatic oxygenation estimated by ShvO 2 was well maintained during normothermic CPB in human beings during sufentanil and propofol anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…One possible cause for the development of hepatic complications is a disturbance of the hepato‐intestinal circulation and an imbalance of hepatic blood supply and demand during CPB [2]. There have been several reports describing the alteration of the intestinal or hepatic circulation during CPB [3–6]. In these reports, the balance between hepatic blood supply and demand is measured by an oximetric balloon catheter inserted into a hepatic vein.…”

Section: Introductionmentioning

confidence: 99%

Disturbances in hepatocellular function during cardiopulmonary bypass using propofol anaesthesia

et al. 2001

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Study in three different types of cardiopulmonary bypass on arterial ketone body ratio: its prognostic implication and participation of body temperature

Nakamura

Onitsuka

Yano

et al. 2003

Interactive Cardiovascular and Thoracic Surgery

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The aim of this study was to investigate the change of hepatic metabolic activity presented by the ketone body ratio (AKBR) during and after cardiopulmonary bypass (CPB) and to evaluate the prognostic value. AKBR were measured in 20 cases of coronary aortic bypass grafting using moderate hypothermic CPB (group M), ten cases of aortic arch surgery using deep hypothermia with selective cerebral perfusion (DHSCP) with an open technique (group D) and 15 cases of descending thoracic aortic replacement using partial CPB (group N). AKBR decreased significantly in all groups 5 min after CPB compared with the value before CPB. There was a significant difference in AKBR 1 h after CPB among the three groups and AKBR returned to the prebypass value in group N (group M, 0.32 +/- 0.16; group D, 0.14 +/- 0.04; group N, 0.48 +/- 0.14; P < 0.0001). AKBR rose significantly after the discontinuation of CPB compared with the value during CPB and returned to the prebypass value in groups M and D. The patients who underwent DHSCP with an open technique had a value of AKBR below 0.2, but liver function still recovered normally. The value of AKBR correlated with temperature significantly and a very low level of AKBR below 0.2 was observed during core cooling to 20 degrees C without negative prognostic implications. AKBR decreased 5 min after CPB in group N which suggested decreased hepatic perfusion at an early stage of partial CPB. The prognostic implication of AKBR during CPB is whether low level AKBR recovers or not.

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Influences of Cardiopulmonary Bypass and Fentanyl Anesthesia on Hepatic Circulation and Oxygen Metabolism in Beagles

Cited by 3 publications

References 15 publications

Disturbances in hepatocellular function during cardiopulmonary bypass using propofol anaesthesia

Disturbances in hepatocellular function during cardiopulmonary bypass using propofol anaesthesia

Disturbances in hepatocellular function during cardiopulmonary bypass using propofol anaesthesia

Study in three different types of cardiopulmonary bypass on arterial ketone body ratio: its prognostic implication and participation of body temperature

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