Evaluation of intraoperative infusion solution using a complete anhepatic model in baby pigs
Evaluation of intraoperative infusion solution using a complete anhepatic model in baby pigs
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DOI：
10.1016/j.transproceed.2005.03.104
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发表时间：
2005-06-01
影响因子：
0.9
通讯作者：
Kobayashi, E
中科院分区：
文献类型：
--
作者：
Komiya, K;Sato, Y;Kobayashi, E
活体相关肝移植（LRLT）与尸体肝移植相比，具有避免下腔静脉（IVC）非系统性夹持导致血流动力学改变的生理优势。然而，血糖和乳酸水平的代谢变化通常发生在LRLT的无肝期。对于儿科患者，术中输液有可能在LRLT期间维持不成熟的体内平衡。在本研究中，采用肝素包被管作为内分流剂，对仔猪进行乳酸林格液（LR, Lactec）、醋酸林格液（AR, VeenF）和醋酸林格液与1%葡萄糖（AR- g, Phisio140）的混合溶液的测试，建立了一种模拟儿科LRLT过程的非全体性IVC夹闭仔猪的完全无肝模型。在无肝期观察血流动力学和代谢（血气分析、电解质、血乳酸和葡萄糖）的变化。尽管三种溶液组在血流动力学参数、动脉血气数据或电解质浓度方面没有观察到重大差异，但在LR组中观察到明显的进行性高乳酸血症。此外，尽管在LR和AR组中发现严重的低血糖，AR- g组在整个无肝期维持血糖水平。总之，使用简化的猪无肝模型，我们评估了儿科LRLT的各种解决方案。
Compared to cadaveric liver transplantation, living-related liver transplantation (LRLT) has the physiological advantage of avoiding hemodynamic changes due to the nonsystemic clamping of the inferior vena cava (IVC). However, metabolic changes in the level of blood glucose and lactate usually occur during the anhepatic phase in LRLT. For pediatric patients, intraoperative infusions have the potential to maintain immature homeostasis during LRLT. In the present study, a complete anhepatic model of baby pigs with nonsystemic clamping of IVC, which mimics the procedure of pediatric LRLT, was established using a heparin-coated tube as an internal shunt lactate Ringer solution (LR, Lactec), acetate Ringer solution (AR, VeenF), and a solution comprising acetate Ringer with 1% glucose (AR-G, Phisio140) were tested using piglets. Hemodynamic and metabolic (blood gas analysis, electrolytes, blood lactate, and glucose) changes were observed during the anhepatic phase. Although no major difference was observed in hemodynamic parameters, arterial blood gas data, or concentration of electrolytes among the three solution groups, significant progressive hyperlactatemia was observed in the LR group. Also, though severe hypoglycemia was found in the LR and AR groups, the AR-G group maintained blood glucose levels throughout the anhepatic phase. To conclude, using the simplified pig anhepatic model, we evaluated various solutions for pediatric LRLT.