Korean J Crit Care Med.  2004 Dec;19(2):115-120.

Hemodynamic Changes during Isolated Liver Hemoperfusion of Hepatoma

• Ha SJ
• Hwang YJ
• Lim DG

Abstract

BACKGROUND
To analyze hemodynamic changes during single catheter technique of hepatic venous isolation and extracorporeal charcoal hemoperfusion for malignant liver tumor. METHODS: Drugs for chemotherapy were infused to the liver through hepatic artery. With 4-lumen- 2-balloon (4L-2B) catheter, hepatic venous blood was circulated to the extracorporeal charcoal system. During extracorporeal charcoal system circulation, drugs were eliminated and the blood was reinfused to supra-hepatic vein-IVC. At the same time, IVC was clamped. Systemic vascular resistance index (SVRI), cardiac index (CI), stroke volume index (SVI), mean arterial pressure (MAP), heart rate (HR) and arterial blood gas were measured after 4L-2B catheter insertion (T1), during test circulation (T2), after 20min chemotherapy (T3) and after 10min reperfusion (T4). RESULTS: MAP was decreased at T3 compared to T1 and increased at T4 compared to T3. CI was decreased at T3 and increased at T4 compared to T1. SVRI was decreased at T4 compared to T1. HR was increased at T2 and T3 compared to T1. SVI was decreased at T2 and T3 compared to T1. CONCLUSIONS: During clamping of IVC, MAP is decreased by decreased SVI in spite of increased HR. After IVC is released and the stagnated blood of lower extremity is recirculated, the MAP is returned to the value of after catheter insertion by increased SVI in spite of decreased SVRI.

Keyword

Blood pressure; Hemodynamic; Hemoperfusion

MeSH Terms

Arterial Pressure
Blood Pressure
Carcinoma, Hepatocellular*
Catheters
Charcoal
Constriction
Drug Therapy
Heart Rate
Hemodynamics*
Hemoperfusion*
Hepatic Artery
Liver*
Lower Extremity
Reperfusion
Stroke Volume
Vascular Resistance
Charcoal