Table of Contents
ISRN Anesthesiology
Volume 2011, Article ID 278545, 6 pages
http://dx.doi.org/10.5402/2011/278545
Research Article

Hemodynamic Changes during Hepatic Vascular Exclusion: Use of Intraoperative Transesophageal Echocardiography a Case Series

Department of Anaesthesiology and Pain Management, University of L'Aquila, 67100 L'Aquila, Italy

Received 15 May 2011; Accepted 22 June 2011

Academic Editors: Y. Mehta and C. Motamed

Copyright © 2011 Franco Marinangeli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this clinical observation was to compare intraoperative transesophageal echocardiography (TEE) and pulmonary artery catheterization (PAC) during hepatic vascular exclusion (HEV). Five non-cirrhotic patients to undergo HVE for major liver resection have been observed. Hemodynamic parameters: pulmonary arterial wedge pressure (PCWP), cardiac index (CI), cardiac output (CO), and systemic vascular resistance (SVR) have been monitored by PAC. Left ventricular end-diastolic area (LVEDA), left ventricular end-systolic area (LVESA), left ventricular end-diastolic pressure (LVEDP), cardiac index (CI), cardiac output (CO), and fractional area changes (FAC) have been monitored by TEE. Hemodynamic variables were assessed before clamping ( 𝑇 0 ), at 5 and 30 minutes after clamping ( 𝑇 1 , 𝑇 2 ) and 15 minutes after unclamping ( 𝑇 3 ). No significant difference between PCWP and LVEDP was found. LVEDP significantly decreased at 𝑇 1 and 𝑇 2 compared to 𝑇 0 ( 𝑃 < 0 . 0 0 1 ); PCWP showed the same trend. A correlation was found between SV and LVEDP ( 𝑅 2 = 0 . 7 5 5 , 𝑃 < 0 . 0 0 1 ) as well as CI ( 𝑅 2 = 0 . 6 3 0 , 𝑃 < 0 . 0 0 1 ). Data confirm that intraoperative TEE may be a reliable method for hemodynamic monitoring during major liver resections.