The effects of vasopressors on perfusion of gastric graft after esophagectomy. An experimental study

Aims To evaluate the impact of the perioperative administration of norepinephrine on the perfusion of the esophageal graft. Methods This is an experimental study. Six swine underwent transhiatal esophagectomy; the stomach was used to replace the resected esophagus. We provoked hemorrhagic shock to the animals and then we administered noradrenaline to restore the blood pressure. We monitored the graft perfusion perioperatively using the technique of microdialysis. Results In all animals, the graft experienced severe hypoperfusion after the administration of noradrenaline that was statistically significant. Conclusions Our data support the hypothesis that norepinephrine should be used with extreme caution in the perioperative setting after esophagectomy. Further studies, however, will be required to evaluate the clinical significance of this finding.