Changes in Hepatic Blood Flow and Liver Function during Closed Abdominal Hyperthermic Intraperitoneal Chemotherapy following Cytoreduction Surgery

Table 1

Intraoperative changes in hepatic, systemic, respiratory, and blood gas parameters.

	Time 0	Time 1	Time 2	Time 3	Time 4	value
RHVI blood flow (ml/min/m^2)	172 (104–213)	214 (103–290)	215 (97–265)	Unmeasurable	197 (125–233)	<0.001
MHVI blood flow (ml/min/m^2)	75 (68–172)	98 (77–172)	97 (68–134)	Unmeasurable	128 (110–164)	<0.001
ICG-PDR (%/min)	23 (20–30)	22 (20–24)	21 (19–24)	18 (13–19)	27 (24–39)	<0.001
Heart rate (beats/min)	64 (55–72)	72 (60–85)	79 (66–80)	82 (70–91)	80 (78–93)	<0.001
MAP (mmHg)	65 (59–92)	80 (70–88)	74 (70–83)	74 (69–80)	74 (66–88)	0.619
Cardiac index (ml/min/m^2)	2.6 (2.2–2.9)	3.1 (2.4–3.5)	2.8 (2.4–3.1)	2.5 (1.9–3.0)	3.2 (2.9–3.8)	0.006
LVEF (%)	63 (52–65)	63 (56–70)	65 (57–73)	50 (38–52)	64 (60–70)	<0.001
SVV (%)	6 (4–8)	7 (5–13)	9 (7–11)	16 (10–21)	8 (6–10)	<0.001
PPV (%)	8 (5–10)	8 (7–15)	10 (9–13)	19 (12–27)	11 (8–15)	<0.001
IVC diameter (cm)	1.78 (1.37–2.04)	1.60 (1.39–1.95)	1.60 (1.40–1.98)	1.14 (0.90–1.30)	1.93 (1.67–2.12)	<0.001
Cumulated (diuresis ml)	30 (0–100)	300 (140–400)	450 (300–800)	550 (380–1100)	700 (460–1170)	<0.001
Compliance (ml/cm H2O)	48.5 (37–52)	42.0 (34–56)	48.5 (31–63)	27.0 (16–30)	34.5 (24–50)	<0.001
Plateau pressure (cm H2O)	16 (13–21)	17 (14–21)	15 (14–23)	27 (25–29)	20 (17–24)	<0.001
PaO2/FiO2 (mmHg)	373 (304–446)	310 (278–434)	450 (379–516)	280^† (196–405)	325 (228–399)	0.027
PaCO2 (mmHg)	36 (30–38)	31 (29–37)	34 (32–38)	32 (29–34)	36 (31–40)	0.264
pH	7.42 (7.40–7.48)	7.41 (7.38–7.46)	7.39 (7.37–7.43)	7.37 (7.32–7.40)	7.32 (7.29–7.35)	<0.001
Serum lactate (mmol/l)	0.95 (0.7–1.2)	0.90 (0.7–1.4)	1.70 (0.9–3.3)	1.90 (1.6–2.9)	2.80 (1.7–3)	<0.001

Data are expressed as median (quartile 25–quartile 75). value results from a Friedman’s two-way analysis of variance by rank. indicates a significantly different value compared to baseline and † indicates a significantly different value compared to time 2 value with the Wilcoxon signed-rank test. RHVI: right hepatic vein index; MHVI: middle hepatic vein index; ICG-PDR: indocyanine green plasma disappearance rate; MAP: mean arterial pressure; LVEF: left ventricle ejection fraction; SVV: stroke volume variation; PVV: pulse pressure variation; IVC: inferior vena cava; PaO₂: arterial oxygen partial pressure; FiO₂: inspired oxygen fraction; PaCO₂: arterial carbon dioxide partial pressure. Time 0: after induction of general anaesthesia, before starting epidural analgesia. Time 1: 30 min after beginning epidural analgesia. Time 2: end of CRS, before abdominal filling. Time 3: end of HIPEC, before abdominal emptying. Time 4: end of procedure, after abdominal emptying and removal of abdominal drainage.