T. Kawasaki et al., WHOLE-BODY OXYGEN-CONSUMPTION DURING EXTRACORPOREAL HEPATIC RESECTION- USEFULNESS OF CONTINUOUS MONITORING OF MIXED VENOUS OXYGEN-SATURATION, Journal of gastroenterology and hepatology, 8(4), 1993, pp. 394-398
Whole body oxygen consumption was measured using a thermodilution fibr
eoptic catheter in two patients undergoing extracorporeal hepatic rese
ction. Each patient had virtually normal liver function before the ope
ration. Anaesthesia was induced and maintained in a standard fashion a
nd a venovenous bypass instituted. The anhepatic periods were 302 and
157 min. Upon removal of the liver, the oxygen consumption decreased b
y about 40% (50 mL/min), while the mixed venous oxygen saturation incr
eased by about 15%. Following re-implantation, the oxygen consumption
recovered and increased transiently above control values, while the mi
xed venous oxygen saturation changed in a reciprocal way. Monitoring w
hole body oxygen consumption instead of hepatic oxygen consumption see
med helpful in estimating restoration of blood flow and functions in t
he liver after reperfusion. It was also suggested that changes in oxyg
en consumption as well as those in cardiac output and haemoglobin conc
entration could be predicted easily by continuous monitoring of mixed
venous oxygen saturation during the peri-anhepatic period.