Changes in acid-base balance during electrolytic ablation in an ex vivo perfused liver model

被引:10
作者
Gravante, Gianpiero [1 ]
Ong, Seok Ling [1 ]
Metcalfe, Matthew S. [1 ]
Sorge, Roberto [2 ]
Fox, Andrew J. [3 ]
Lloyd, David M. [4 ]
Maddern, Guy J. [4 ,5 ]
Dennison, Ashley R. [1 ]
机构
[1] Leicester Gen Hosp, Dept Hepatobiliary & Pancreat Surg, Leicester LE5 4PW, Leics, England
[2] Univ Roma Tor Vergata, Dept Human Physiol, Lab Biometry, Rome, Italy
[3] Leicester Gen Hosp, Dept Anaesthesia & Crit Care Med, Leicester LE5 4PW, Leics, England
[4] Royal Infirm Hosp, Dept Hepatobiliary & Pancreat Surg, Leicester, Leics, England
[5] Univ Adelaide, Queen Elizabeth Hosp, Dept Surg, Woodville, Australia
关键词
Ex vivo; Liver; Acid base; pH; Electrolytic ablation; INDUCED HEPATIC-NECROSIS; EFFICACY; INJURY; SAFETY; TISSUE; TUMORS;
D O I
10.1016/j.amjsurg.2009.12.019
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Electrolytic ablation (EA) destroys tissues through extreme pH changes in the local microenvironment. An ex vivo perfused liver model was used to assess the systemic effects of EA on the acid-base balance without the influence of compensatory organs (lungs and kidneys). METHODS: Eleven pigs were perfused extracorporeally at 39 degrees C with autologous blood; 4 also underwent EA after 1 hour of reperfusion. Arterial blood samples were obtained hourly. RESULTS: pH and CO2 levels did not change throughout the experiments. A significant increase of HCO3-, anion gap, base excess, and lactate was present after the third hour. No differences were observed between EA experiments and controls. CONCLUSIONS: EA does not alter the acid-base balance even when the confounding influence of compensatory organs is removed. Such findings should be considered when planning ablations in patients with renal failure or respiratory diseases in which EA could avoid undesirable metabolic changes. (C) 2012 Elsevier Inc. All rights reserved.
引用
收藏
页码:666 / 670
页数:5
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