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Korean J Crit Care Med > Volume 19(2); 2004 > Article
Korean Journal of Critical Care Medicine 2004;19(2): 115-120.
원저 : 체외순환을 이용한 간암의 항암요법 시 혈역학적 변화
하성조, 황윤진, 임동건
경북대학교 의과대학 마취통증의학교실 및 *외과학교실
Hemodynamic Changes during Isolated Liver Hemoperfusion of Hepatoma
Seong Jo Ha, Yoon Jin Hwang, Dong Gun Lim
1Department of Anesthesiology and Pain Medicine, Kyungpook National University, Daegu, Korea. dglim@knu.ac.kr
2Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea.
BACKGROUND: To analyze hemodynamic changes during single catheter technique of hepatic venous isolation and extracorporeal charcoal hemoperfusion for malignant liver tumor. METHODS: Drugs for chemotherapy were infused to the liver through hepatic artery. With 4-lumen- 2-balloon (4L-2B) catheter, hepatic venous blood was circulated to the extracorporeal charcoal system. During extracorporeal charcoal system circulation, drugs were eliminated and the blood was reinfused to supra-hepatic vein-IVC. At the same time, IVC was clamped. Systemic vascular resistance index (SVRI), cardiac index (CI), stroke volume index (SVI), mean arterial pressure (MAP), heart rate (HR) and arterial blood gas were measured after 4L-2B catheter insertion (T1), during test circulation (T2), after 20min chemotherapy (T3) and after 10min reperfusion (T4). RESULTS: MAP was decreased at T3 compared to T1 and increased at T4 compared to T3. CI was decreased at T3 and increased at T4 compared to T1. SVRI was decreased at T4 compared to T1. HR was increased at T2 and T3 compared to T1. SVI was decreased at T2 and T3 compared to T1. CONCLUSIONS: During clamping of IVC, MAP is decreased by decreased SVI in spite of increased HR. After IVC is released and the stagnated blood of lower extremity is recirculated, the MAP is returned to the value of after catheter insertion by increased SVI in spite of decreased SVRI.
Key Words: Blood pressure; Hemodynamic; Hemoperfusion
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