Lactate is correlated with the indocyanine green elimination rate in liverresection for cirrhotic patients

The role of lactate in liver ischemia-reperfusion injury in cirrhosis has n ot been clarified. Fifty patients with hepatocellular carcinoma who underwe nt partial liver resection under Pringle's maneuver were included in this s tudy. We performed the indocyanine green clearance test before the operatio n and three times during the surgery to calculate its elimination rate. Blo od lactate and base excess were measured at the corresponding times. Systol ic and diastolic systemic arterial pressure, heart rate, cardiac index, and esophageal temperature were monitored. Aminotransferase levels were record ed the day before the operation, 1 h after the operation, and on the first and third postoperative days. We calculated the increase or decrease in lac tate levels during the preischemic, ischemic, and postischemic phases, and examined the correlation between these results and the changes in indocyani ne green elimination rate and some clinical factors. The lactate levels inc reased before reperfusion and began to decrease after reperfusion. The lact ate increase and decrease during the ischemic and postischemic phases corre lated with the change in indocyanine green elimination rate (P < 0.0001 and P = 0.02 for the respective phases). The lactate increase during the preis chemic phase correlated with the duration of the preischemic phase (P < 0.0 001). Ln cirrhotic patients who undergo liver resection with Pringle's mane uver and who do not show postoperative liver failure, the blood lactate pro file might be a reliable indicator of liver metabolic capacity during surge ry.