승압제 투여 후 Thermal Diffusion Probe로 측정한 간 미세혈류의 변화
Changes of Hepatic Microcirculation Measured by Thermal Diffusion Probe after Vasopressor Infusion
전장용, 이승규, 최규택,
소속 상세정보
전장용 ( Jeon Jang-Yong )
한림대학교 의과대학 외과학교실
이승규 ( Lee Sung-Gyu )
울산대학교 의과대학 서울아산병원 외과학교실
최규택 ( Choi Kyu-Taek )
울산대학교 의과대학 서울아산병원 마취통증의학교실
KMID : 0371320030640040312
Abstract
PURPOSE: Various vasopressor agents are used to raise systemic vascular resistance (SVR) during liver transplantation. After grafted liver was reperfused, postreperfusion syndrome could be treated with various vasopressors. However, epinephrine can decrease the splanchnic perfusion and oxygen saturation and then hepatic blood flow would be jeopardized. Decreased hepatic blood flow might result in centrilobular necrosis which contributes to disruption of liver functions. We tried to know the effect of epinephrine on tissue perfusion of the liver.
METHODS: In this study, measurement of hepatic microcirculation (HMC) and hemodynamic changes was performed in eight dogs to investigate the effect of vasopressors on hepatic microcirculation. Animals were divided into four groups in which low-dose epinephrine (0.05 micro g/Kg/min) and high-dose epinephrine (0.5 micro g/Kg/min) were randomly infused into the systemic vein and portal vein (1/6 of systemic dose) for ten minutes. Hepatic microcirculation was measured by Thermal Diffusion Probe.
RESULTS: At low-dose systemic infusion of epinephrine, mean arterial bloodpressure (MABP), cardiac output (CO), and hepatic microcirculation (HMC) were significantly increased but systemic vascular resistance (SVR) was decreased. On high-dose epinephrine, MABP, CO (P=0.01), and SVR were significantly increased without changes of HMC. Intraportal infusion of low- and high-dose epinephrine increased hepatic vein pressure and SVR, respectively.
CONCLUSION: These results would provide clues that systemic low-dose epinephrine infusion is enough to raise HMC and high-dose infusion of epinephrine to raise SVR could be used without jeopardizing HMC.
키워드
혈역학적 변화;간 미세혈류;간이식;열확산 프루브
Hemodynamic change;Hepatic microcirculation;Liver transplantation;Thermal diffusion probe
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