Korean J Anesthesiol.  1999 Oct;37(4):631-636. 10.4097/kjae.1999.37.4.631.

Acid-Base Status without Sodium Bicarbonate Administration during Orthotopic Liver Transplantation

• Lee YM
• Gwak MS
• Cho HS
• Kim GS

• KMID: 2091464
• DOI: http://doi.org/10.4097/kjae.1999.37.4.631

Abstract

BACKGROUND: Marked derangements in acid-base status are frequently seen during orthotopic liver transplantaton. To prevent the progression of metabolic acidosis, treatment with sodium bicarbonate has been recommended. However, sodium bicarbonate may exacerbate intracellular acidosis, increase plasma lactate, contribute to hypernatremia. The value of giving bicarbonate has been questioned. Accordingly, we reviewed the intraoperative the acid-base status of patients who underwent orthotopic liver transplatation.
METHODS
We reviewed ten patients showed severe metabolic acidosis (7.2 < pH < 7.30 and base deficit (BD) > or = 10). Despite of BD > or = 10, sodium bicarbonate was not given to all. Intraoperative pH and BD were analyzed retrospectively.
RESULTS
At the anhepatic and immediate post-reperfusion periods, the pH was decreased (P < 0.05) and BD was increased (P < 0.05), but both were normalized at the end of surgery. The mean blood pressure transiently decreased at the immediate post-reperfusion periods (P < 0.05), but that was acceptable.
CONCLUSIONS
This study showed that a severe metabolic acidosis is tolerated by the patients undergoing orthotopic liver transplantation without administration of sodium bicarbonate.

Keyword

Acid-base equilibrium, metabolic acidosis; Sodium bicarbonate; Transplantation, liver

MeSH Terms

Acidosis
Blood Pressure
Humans
Hydrogen-Ion Concentration
Hypernatremia
Lactic Acid
Liver Transplantation*
Liver*
Plasma
Retrospective Studies
Sodium Bicarbonate*
Sodium*
Lactic Acid
Sodium
Sodium Bicarbonate