Changs In Oxygen Metabolism Of Tissues And Gastric Intramucosal PH During Orthotopic Liver Transplantation Without Veno-venous Bypass

Objective To investigate the Changs in oxygen metabolism and pHi of tissues during orthotopic liver transplantation(OLT) without veno-venous bypass. Methods Twenty-one patients with end disease of hepatism were scheduled for first OUT without veno-venous bypass under combined general anesthesia. Before induction of general anesthesia, pulmonary artery cather was inserted into right jugular vein and two arterial line was put in the left and right radial artery to measure hemodynamics, after induction of general anesthesia and endotracheal intubation, tonometer nasogastric tube was positioned in the stomach to determine the intramucosal pH.Blood samples were taken from radial and pulmonary artery for blood gas analysis .Hemodynamics parameters ,and oxygenation parameters ,ang blood gas analysis parameters, pHi, PgCO2, were recorded and calculated in postinduction of general anesthesia 30min(T0) ,cross-clamping of inferior vena cava and portal vein (T1)and unclamping of inferior vena cava and portal vein 5min(T2),90min after graft reperfusion(T3)and the end of operation(T4).Result As compared withpostinduction of general anesthesia (T 0 ),DO2 were significantly decreased at T1 (p<0.001); VO2 rose at T4; PgCO2 was increased at T1 T2;T2 was more significantly increased ;pHi was decreased markedly at T1,T2,T3,T4 '(p<0.05 ) , and T2 is lower than others (p<0.001) .Conclusion There is severe changes in oxygen metabolism of tissues and pHi during orthotopic liver transplantation(OLT) without veno-venous bypass, The early monitoring and management during operation is helpful for these patients after operation,...