Liver ischemia, catecholamines and preoperative condition influencing postoperative tachycardia in liver surgery

CSA – Clinical Stress Assessment

“…But low Mg in those patients may be not only a marker of increasing metabolic exhaustion, but could actively contribute to wasteful anaerobic glycolysis by limiting ATP -ADP turnover. At least in non diabetic patients, we could show that low magnesium concentrations before extensive liver surgery deteriorate the prognosis about the final outcome significantly (21). The most important result concerning type2 diabetics is unquestionably the highly significant negative correlation between Mg levels and blood glucose above the hypomagnesemic threshold.…”

Präoperative Katecholamin-Effekte auf Blutfette und Magnesiumwerte können ein Leberversagen nach Leberresektionen vorhersagen

“…Previously, we demonstrated that perioperative tachycardia induced by hypercatecholaminemia usually indicates postoperative complications [1]. Table 2.…”

“…Our earlier work [1] showed that catecholamine-induced perioperative tachycardic events are closely related to the postoperative course.…”

Metabolic changes and hypomagnesiemia

“…We could show in this paper, that at least base -excess diminishment, lactate decrease and a fall in blood glucose average -whose wide ranging correlation is shown in Figure 8 -is significant already in the group with Mg-H-H averages below 0.5 mM/l and above 0.45 mM/l. It remains undisputed that below Mg-H-tlevels of 0.45 mMJl severe metabolic changes are evident, which may even be markers for the outcome of liver surgery [6,8,17]. But we also have to accept that metabolic deterioration is already significant in some important cases above 0.45 mM/l and below 0.5 mM/l.…”