Changes of oxygen metabolic parameters and blood glucose concentrations during perioperative period of orthotopic liver transplantation

Objective:To investigate the changes of oxygen metabolic parameters and blood glucose concentrations during perioperative period of orthotopic liver transplantation.Methods: The blood gas,cardiac index(CI),mixed venous oxygen saturation(SvO_(2)),oxygen delivery(DO_(2)),oxygen consumption(VO_(2)),oxygen extraction rate(O_(2)ER),and arterial blood glucose were measured at defined time points(before anesthesia induction,30 min before anhepatic period,5 min after anhepatic period,30 min after anhepatic period,5 min of neohepatic period,30 min of neohepatic period,and postoperation) in 50 patients receiving liver transplantation.Results: Compared with those before anesthesia induction,no significant changes in CI,SvO_(2),DO_(2),VO_(2),and O_(2)ER were found in pre-anhepatic period.CI,VO_(2),and DO_(2) decreased significantly at the early 5 min of the anhepatic period(P0.05);VO_(2),DO_(2),and O_(2)ER decreased significantly at the 30 min of the anhepatic stage(P0.05). SvO_(2),DO_(2),and VO_(2) increased,but O_(2)ER decreased significantly at the early 5 min of the neohepatic stage(P0.05).DO_(2),VO_(2),and O_(2)ER increased significantly at the 30 min of the neohepatic stage(P0.05).During preanhepatic stage the blood glucose levels increased progressively but were lower than those during anhepatic stage.During neohepatic stage,blood glucose decreased abruptly but was still higher than the normal level(P0.05).Conclusion: It suggests that serious imbalance of oxygen metabolism exists during liver transplantation,especially in anhepatic and early neohepatic stages.Blood glucose increases during the preanhepatic stage,reaches the peak during the anhepatic stage,and then decreases gradually.