Effects on liver function

Andre M. De Wolf, Jan F.A. Hendrickx

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Liver surgery can be remarkably safe: A zero mortality rate has been achieved with liver resections when patients are properly selected and with meticulous perioperative care [1]. In order to maintain liver function in individual patients undergoing anaesthesia and surgery, the single most important factor is maintaining its perfusion. In order to avoid hypoxic liver injury, preserving sinusoidal blood flow is best done by maintaining an adequate perfusion pressure and avoiding a high central venous pressure. Reducing intraoperative blood loss and maintaining systemic haemodynamics likely play major roles in avoiding hypoxic liver injury. It is still unknown which vasoactive drugs are preferred when haemodynamic instability occurs; Noradrenaline seems to be well tolerated as long as hypovolaemia is avoided. Ischaemic preconditioning and pharmacological preconditioning and postconditioning are promising, but their clinical relevance remains to be determined. Finally there are no good markers of hepatocyte damage that could be used intraoperatively to optimize anaesthetic management.

Original languageEnglish (US)
Title of host publicationPersonalized Anaesthesia
Subtitle of host publicationTargeting Physiological Systems for Optimal Effect
PublisherCambridge University Press
Pages245-256
Number of pages12
ISBN (Electronic)9781316443217
ISBN (Print)9781107579255
DOIs
StatePublished - Jan 1 2019

ASJC Scopus subject areas

  • Medicine(all)

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