Выход
Вход/Login
 
E-mail
Пароль/Password
Забыли пароль?
Введите E-mail и жмите тут. Пароль будет выслан на указанный адрес
Войти (LogIn)

 

Если вы первый раз здесь, то зарегистрируйтесь

Регистрация/Sign Up
Полное имя (Ф.И.О.)/Name
E-mail
Телефон/Phone
Зарегистрироваться,
на ваш E-mail будет выслан временный пароль

 

Медицинская литература. Новинки


 

 

 

 

 

 
вce журналы << Анналы хирургической гепатологии << 2016 год << №2 <<
стр.39
отметить
статью

Протокол анестезии при обширных резекциях печени: смена парадигмы под влиянием опыта трансплантации печени (обзор литературы)

Бельский В. А., Мольков А. М., Уткин И. А., Рабосина И. А., Загайнов В. Е.
Вы можете загрузить полный текст статьи в формате pdf
Бельский Владислав Александрович - главный специалист по анестезиологии-реаниматологии ФБУЗ ПОМЦ ФМБА России, ФБУЗ “Приволжский окружной медицинский центр” ФМБА России, 603109, г. Нижний Новгород, ул. Ильинская, д. 14, Российская Федерация
Мольков Александр Михайлович - врач анестезиолог-реаниматолог отделения анестезиологии - реанимации ФБУЗ ПОМЦ ФМБА России, ФБУЗ “Приволжский окружной медицинский центр” ФМБА России, 603109, г. Нижний Новгород, ул. Ильинская, д. 14, Российская Федерация
Уткин Иван Александрович - врач анестезиолог-реаниматолог отделения анестезиологии - реанимации ФБУЗ ПОМЦ ФМБА России, ФБУЗ “Приволжский окружной медицинский центр” ФМБА России, 603109, г. Нижний Новгород, ул. Ильинская, д. 14, Российская Федерация
Рабосина Ирина Анатольевна - врач анестезиолог-реаниматолог отделения анестезиологии - реанимации ФБУЗ ПОМЦ ФМБА России, ФБУЗ “Приволжский окружной медицинский центр” ФМБА России, 603109, г. Нижний Новгород, ул. Ильинская, д. 14, Российская Федерация
Загайнов Владимир Евгеньевич - доктор мед. наук, главный специалист по хирургии ФБУЗ ПОМЦ ФМБА России, заведующий кафедрой хирургических болезней ГБОУ ВПО НижГМА Минздрава России, ФБУЗ “Приволжский окружной медицинский центр” ФМБА России; ГБОУ ВПО “Нижегородская государственная медицинская академия” Минздрава России, vlad.belsky@gmail.com, 603109, г. Нижний Новгород, ул. Ильинская, д. 14, Российская Федерация

Представлен обзор современной актуальной литературы, включающий доказательные исследования, методические рекомендации, стандарты, руководства, посвященные анестезиологическому обеспечению расширенных резекций печени. На основании собранного материала проведен анализ существующих алгоритмов анестезии. Отмечены существенные различия подходов к анестезиологическому обеспечению, которые преимущественно обусловлены проблемой массивной интраоперационной кровопотери. Расширяющаяся практика трансплантации печени вносит существенные коррективы в проведение анестезии при этих оперативных вмешательствах. С учетом накопленного опыта обширных резекций и трансплантации печени выбран оптимальный алгоритм анестезиологического обеспечения.

Ключевые слова:
анестезия, печень, обширная резекция, мониторинг, инфузионная терапия, трансплантация, anesthesia, liver, extended liver resection, monitoring, infusion therapy, transplantation

Литература:
1.Готье С.В., Филин А.В., Цирульникова О.М. Обширные анатомические резекции в лечении очаговых поражений печени. Анналы Российского научного центра хирургии Российской академии медицинских наук. 2000; 9: 12-18.
2.Clavien P.A., Petrowsky H., DeOliveira M.L., Graf R. Strategies for safer liver surgery and partial liver transplantation. N. Engl. J. Med. 2007; 356 (15): 1545-1559. PMID: 17429086.
3.Лихванцев В.В., Смирнова В.И., Вишневский В.А., Озерова Н.В., Ситников А.В., Субботин В.В. Анестезиологическое обеспечение операций на печени. Анналы хирургической гепатологии. 1998; 3 (1): 117-126.
4.Wagener G. Liver anesthesiology and critical care medicine. New York: Springer New York Heidelberg Dordrecht London, 2013. 373 p.
5.Kehlet H., Wilmore D.W. Evidence-based surgical care and the evolution of fast-track surgery. Ann. Surg. 2008; 248 (2): 189-198. doi: 10.1097/SLA.0b013e31817f2c1a. PMID: 18650627.
6.Дзядзько А.М., Щерба А.Е., Болонкин Л.С., Минов А.Ф., Сантоцкий Е.О. Анестезиологическое обеспечение и периоперационная интенсивная терапия в резекционной хирургии печени. Минск: Белорусская медицинская академия последипломного образования, 2012. 39 c.
7.Smyrniotis V., Kostopanagiotou G., Kondi A., Gamaletsos E., Theodoraki K., Kehagias D., Mystakidou K., Contis J. Hemodynamic interaction between portal vein and hepatic artery flow in small for-size split liver transplantation. Transpl. Int. 2002; 15 (7): 355-360. PMID: 12122512.
8.Podolsky D.K., Camilleri M., Fitz J.G., Kalloo A.N., Shanahan F., Wang T.C. Yamada''s Textbook of Gastroenterology. United States: John Wiley & Sons Inc. 2015; 2 Volume Set 6th Edition. 3440 p.
9.Demetris A.J., Kelly D.M., Eghtesad B., Fontes P., Wallis M.J., Tom K., Tan H.P., Shaw-Stiffel T., Boig L., Novelli P., Planinsic R., Fung J.J., Marcos A. Pathophysiologic observations and histopathologic recognition of the portal hyperperfusion or small for-size syndrome. Am. J. Surg. Pathol. 2006; 30 (8): 986-993. PMID: 16861970. doi: 10.1097/00000478-200608000-00009.
10.Ozgul U., Ucar M., Erdogan M.A., Aydogan M.S., Toprak H.I., Colak C., Durmus M., Ersoy M.O. Effects of isoflurane and propofol on hepatic and renal functions and coagulation profile after right hepatectomy in living donors. Transplant. Proc. 2013; 45 (3): 966-970. doi: 10.1016/j.transproceed.2013.02.056.
11.Tympa A., Theodoraki K., Tsaroucha A., Arkadopoulos N., Vassiliou I., Smyrniotis V. Anesthetic considerations in hepatectomies under hepatic vascular control. H.P.S. Surgery. 2012: 1-12. doi: org/10.1155/2012/720754.
12.Barash P., Cullen B., Stoelting R., Cahalan M., Stock M.C., Ortega R. Clinical anesthesia. 7th edition. Philadelphia: Lippin cott Williams & Wilkins, a Wolters Kluwer Business, 2013. 1767 p.
13.Erturk E. Ischemia-reperfusion injury and volatile anesthetics. BioMed. Res. Int. 2014; (2014): 7-18. doi: org/10.1155/2014/526301.
14.Browse D.J., Mathie R.T., Irving S., Alexander B. The role of ATP and adenosine in the control of hepatic blood flow in the rabbit liver in vivo. Comp. Hepat. 2003; 2 (1): 9. doi: 10.1186/1476-5926-2-9.
15.Fondevila C., Hessheimer A.J., Taurá P., Sánchez O., Calatayud D., de Riva N., Muñoz J., Fuster J., Rimola A., García-Valdecasas J.C. Portal hyperperfusion: mechanism of injury and stimulus for regeneration in porcine small-for-size transplantation. Liver Transpl. 2010; (16): 364-374. PMID: 20209596. doi: 10.1002/lt.21989.
16.Dahm F., Georgiev P., Clavien P.A. Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications. Am. J. Transplant. 2005; 5 (11): 2605-2610. PMID: 16212618. doi: 10.1111/j.1600-6143.2005.01081.x.
17.Glanemann M., Eipel C., Nussler A.K., Vollmar B., Neuhaus P. Hyperperfusion syndrome in small-for-size livers. Eur. Surg. Res. 2005; 37 (6): 335-341.
18.Fahrner R., Patsenker E., de Gottardi A., Stickel F., Montani M., Stroka D., Candinas D., Beldi G. Elevated liver regeneration in response to pharmacological reduction of elevated portal venous pressure by terlipressin after partial hepatectomy. Transplantation. 2014; 97 (9): 892-900. PMID: 24621531. doi: 10.1097/ TP.0000000000000045.
19.Mukhtar A., Dabbous H. Modulation of splanchnic circulation: Role in perioperative management of liver transplant patients. World J. Gastroenterol. 2016; 22 (4): 1582-1592. doi: 10.3748/wjg.v22.i4.1582. PMID: 26819524.
20.Rinehart J., Lilot M., Lee C., Joosten A., Huynh T., Canales C., Imagawa D., Demirjian A., Cannesson M. Closed-loop assisted versus manual goal-directed fluid therapy during highrisk abdominal surgery: a case-control study with propensity matching. Crit. Care. 2015; 19: 94-104. doi: 10.1186/s13054-015-0827-7.
21.Bergmann I., Göhner A., Crozier T.A., Hesjedal B., Wiese C.H., Popov A.F., Bauer M., Hinz J.M. Surgical pleth indexguided remifentanil administration reduces remifentanil and propofol consumption and shortens recovery times in outpatient anaesthesia. Br. J. Anaesth. 2013; 110 (4): 622-628. doi: 10.1093/bja/aes426.
22.Cao F., Liu X.F., Chen R.L., Wang X.C. Effect of positive endexpiratory pressure on central venous pressure and common iliac venous pressure in mechanically ventilated patients. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2008; 20 (6): 341.
23.Sand L., Rizell M., Houltz E., Karlsen K., Wiklund J., Odenstedt Hergès H., Stenqvist O., Lundin S. Effect of patient position and PEEP on hepatic, portal and central venous pressures during liver resection. Acta Anaesthesiol. Scand. 2011; 55 (9): 1106-1012. doi: 10.1111/j.1399-6576.2011.02502.x.
24.Monnet X., Teboul J.-L. Passive leg raising: five rules, not a drop of fluid! Critical Care. 2015; 19 (1): 18. doi :10.1186/s13054-014-0708-5.
25.Jamieson G.G., Corbel L., Campion J.P., Launois B. Major liver resection without a blood transfusion: is it a realistic objective? Surgery. 1992; 112 (1): 32-36.
26.Li Z., Sun Y.-M., Wu F.-X., Yang L.Q., Zhi-Jie Lu Z.-J., Yu W.-F. Controlled low central venous pressure reduces blood loss and transfusion requirements in hepatectomy. World J. Gastroenterol. 2014; 20 (1): 303-309. doi: 10.3748/wjg.v20.i1.303. PMCID: PMC3886023.
27.Melendez J.A., Arslan V., Fischer M.E. Perioperative outcomes of major hepatic resections under low central venous pressure anaesthesia: blood loss, blood transfusion, and the risk of postoperative renal dysfunction. J. Am. Coll. Surg. 1998; 187 (6): 620-625.
28.Maxwell M.J., Wilson M.J.A. Complications of blood transfusion. Contin. Educ. Anaesth. Crit. Care Pain. 2006; 6 (6): 225-229. doi: 10.1093/bjaceaccp/mkl053.
29.Kooby D.A., Stockman J., Ben-Porat L., Gonen M., Jarnagin W.R., Dematteo R.P., Tuorto S., Wuest D., Blumgart L.H., Fong Y. Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases. Ann. Surg. 2003; 237 (6): 860-870. PMID: 12796583.
30.Katz S.C., Shia J., Liau K.H. Operative blood loss independently predicts recurrence and survival after resection of hepatocellular carcinoma. Ann. Surg. 2009; 249 (4): 617-623. doi: 10.1097/SLA.0b013e31819ed22f.
31.Matot I., Scheinin O., Jurim O. Effectiveness of acute normovolemic hemodilution to minimize allogenic blood transfusion in major liver resections. Anesthesiology. 2002; 97 (4): 794-800.
32.Jarnagin W.R., Gonen M., Shishir K., Maithel S.K., Fong Y., D''Angelica M.I., DeMatteo R.P., Grant F., Wuest D., Kundu K., Blumgart L.H., Fischer M. A prospective randomized trial of acute normovolemic hemodilution compared to standard intraoperative management in patients undergoing major hepatic resection. Ann. Surg. 2008; 248 (3): 360-369. doi: 10.1097/SLA.0b013e318184db08.
33.Corcoran T., Emma J., Rhodes J., Clarke S., Myles P.S., Ho K.M. Perioperative fluid management strategies in major surgery: A stratified meta-analysis. Anesth. Analg. 2012; 114 (3): 640-651. doi: 10.1213/ANE.0b013e318240d6eb.
34.Brandstrup B., Tønnesen H., Beier-Holgersen R., Hjortsø E., Ørding H., Lindorff-Larsen K., Rasmussen M.S., Lanng C., Wallin L., Iversen L.H., Gramkow C.S., Okholm M., Blemmer T., Svendsen P.E., Rottensten H.H., Thage B., Riis J., Jeppesen I.S., Teilum D., Christensen A.M., Graungaard B., Pott F. Danish Study Group on Perioperative Fluid Therapy. Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial. Ann. Surg. 2003; 238 (5): 641-648. doi: 10.1097/01.sla.0000094387.50865.23.
35.Della Rocca G., Vetrugno L., Tripi G., Deana C., Barbariol F., Pompei L. Liberal or restricted fluid administration: are we ready for a proposal of a restricted intraoperative approach? B.M.C. Anesthesiol. 2014; 14: 62. doi: 10.1186/1471-2253-14-62.
36.Sahmeddini M.A., Janatmakan F., Khosravi M.B., Ghaffaripour S., Eghbal M.H., Nickeghbalian S., Malek-Hosseini S.A. Restricted crystalloid fluid therapy during orthotopic liver transplant surgery and its effect on respiratory and renal insufficiency in the early post-operative period: A randomized clinical trial. Int. J. Organ. Transplant. Med. 2014; 5 (3): 113-119. PMID: 25184031.
37.Spelt L., Ansari D., Sturesson C., Tingstedt B., Andersson R. Fast-track programmes for hepatopancreatic resections: where do we stand? H.P.B. 2011; (13): 833-838. doi: 10.1111/j.1477-2574.2011.00391.x.
38.Hughes M.J., McNally S., Wigmore S.J. Enhanced recovery following liver surgery: a systematic review and meta-analysis. H.P.B (Oxford). 2014; 16 (8): 699-706. doi: 10.1111/hpb.12245.
39.Coolsen M., Wong-Lun-Hing E., van Dam R., van der Wilt A., Slim K., Lassen K., Dejong C.H. A systematic review of outcomes in patients undergoing liver surgery in an enhanced recovery after surgery pathways. HPB. 2013; 15 (4): 245-251. doi: 10.1111/j.1477-2574.2012.00572.x.
40.Rivers E., Nguyen B., Havstad S., Ressler J. Early goal-directed therapy in the treatment of severe sepsis and septic shock. New Eng. J. Med. 2001; (19): 1368-1377. PMID: 11794169.
41.Wilms H., Mittal A., Haydock M.D., van den Heever M., Devaud M., Windsor J.A. A systematic review of goal directed fluid therapy: rating of evidence for goals and monitoring methods. J. Crit. Care. 2014; 29 (2): 204-209. doi: 10.1016/j.jcrc.2013.10.019.
42.O’Neal J.B., Shaw A.D. Goal-directed therapy: what we know and what we need to know. Perioper. Med. (Lond.). 2015; 4 (1): 1-3.
43.Pearse R.M., Harrison D.A., MacDonald N., Gillies M.A., Blunt M., Ackland G., Grocott M.P., Ahern A., Griggs K., Scott R., Hinds C., Rowan K. Effect of a perioperative, cardiac output-guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: a randomized clinical trial and systematic review. JAMA. 2014; 311 (21): 2181-2190. doi: 10.1001/jama.2014.5305.
44.Sakamoto M., Kobayashi Y., Tanigawa S., Hidetoshi Miyakawa H., Otsubo T., Tateda T. Acute kidney injury after hepatic surgery with goal directed fluid therapy. St. Marianna Med. J. 2015; 6 (1): 47-54. doi: 10.17264/stmarieng.6.47.
45.Bellamy M.C. Wet, dry or something else? Br. J. Anaesth. 2006; 97 (6): 755-757. PMID: 17098724.
46.Hughes M.J., Ventham N.T., Harrison E.M., Wigmore S.J. Central venous pressure and liver resection: a systematic review and meta-analysis. H.P.B. 2015; 17 (10): 863-871. doi: 10.1111/hpb.12462.
47.Chen H., Merchant N.B., Didolkar M.S. Hepatic resection using intermittent vascular inflow occlusion and low central venous pressure anaesthesia improves morbidity and mortality. J. Gastrointest. Surg. 2000; 4 (2): 162-167. PMID: 10675239.
48.Khokhar R.S., Khan M.M., Khan M.U., Aqil M. Strategies to lower the central venous pressure during liver resections. Anaesth Pain & Intensive Care. 2014; 18 (4): 464-466.
49.Минов А.Ф., Дзядзько А.М., Руммо О.О. Влияние уровня центрального венозного давления на объем кровопотери и потребность в трансфузии при трансплантации печени. Новости хирургии. 2011; 19 (4): 77-82.
50.Oji M., Sakamoto M., Tateda T. Fluid responsiveness predicts hemodynamic change during hepatic surgery. St. Marianna Med J. 2012; (40): 129-139.
51.Hatano Y., Murakawa M., Segawa H. Venous air embolism during hepatic resection. Anesthesiology. 1990; 73 (6): 1282-1285. PMID: 2248411.
52.Mirski M.A., Lele A.V., Fitzsimmons L., Toung T.J.K. Diagnosis and treatment of vascular air embolism. Anesthesiolog. 2007; 106 (1): 164-177. PMID: 17197859.
53.Lee S.Y., Choi B.I.W., Kim J.S., Park K.S. Paradoxical air embolism during hepatic resection. Br. J. Anaesth. 2002; 88 (1): 136-138. doi: 10.1093/bja/88.1.136.
54.Cescon M., Vetrone G., Grazi G.L. Trends in perioperative outcome after hepatic resection: analysis of 1500 consecutive unselected cases over 20 years. Ann. Surg. 2009; 249 (6): 995-1002. doi: 10.1097/SLA.0b013e3181a63c74.
55.Wang С.С., Iyer S.G., Low J.K. Perioperative factors affecting long-term outcomes of 473 consecutive patients undergoing hepatectomy for hepatocellular carcinoma. Ann. Surg. Oncol. 2009; 16 (7): 1832-1842. doi: 10.1245/s10434-009-0448-y.
56.Moug S.J., Smith D., Leen E., Angerson W.J., Horgan P.G. Selective continuous vascular occlusion and perioperative fluid restriction in partial hepatectomy. Outcomes in 101 consecutive patients. Eur. J. Surg. Oncol. 2007; 33 (8): 1036-1041. doi: org/10.1155/2012/720754.
57.Marx G., Schindler A.W., Mosch C., Albers J., Bauer M., Gnass I., Hobohm C., Janssens U., Kluge S., Kranke P., Maurer T., Merz W., Neugebauer E., Quintel M., Senninger N., Trampisch H.-J., Waydhas C., Wildenauer R., Zacharowski K., Eikermann M. Intravascular volume therapy in adults: Guidelines from the Association of the Scientific Medical Societies in Germany. Eur. J. Anaesthesiol. 2016; 33: 488-521. doi: 10.1097/EJA.0000000000000447.
58.Granger D.N., Granger H.J. Systems analysis of intestinal hemodynamics and oxygenation. Am. J. Physiol. 1983; 245 (6): 786-796.
59.Takala J. Determinants of splanchnic blood flow. Br. J. Anaesth. 1977; 77: 50-58.
60.Nygren A., Thorén A., Ricksten S.E. Vasopressors and intestinal mucosal perfusion after cardiac surgery: Norepinephrine vs. phenylephrine. Crit. Care Med. 2006; 34 (3): 722-729. PMID: 16505658.
61.Helling T.S., Blondeau B., Wittek B.J. Perioperative factors and outcome associated with massive blood loss during major liver resections. H.P.B. 2004; 6 (3): 181-185. doi: 10.1080/13651820410030826.
62.Redai I., Emond J., Brentjens T. Anesthetic considerations during liver surgery. Surg. Clin. North Am. 2004; 84 (2): 401-411. PMID: 15062652.
63.Smyrniotis V., Farantos C., Kostopanagiotou G., Arkadopoulos N. Vascular control during hepatectomy: review of methods and results. World J. Surg. 2005; 29 (11): 1384-1396. PMID: 16222453.
64.Figueras J., Llado L., Ruiz D. Complete versus selective portal triad clamping forminor liver resections: a prospective randomized trial. Ann. Surg. 2005; 241 (4): 582-590. doi: 10.1097/01.sla.0000157168.26021.b8.
65.Smyrniotis V.E., Kostopanagiotou G.G., Gamaletsos E.L. Total versus selective hepatic vascular exclusion in major liver resections. Am. J. Surg. 2002; 183 (2): 173-178. PMID: 11918884.
66.Hannoun L., Delrivi`ere L., Gibbs P., Borie D., Vaillant J.C., Delva E. Major extended hepatic resections in diseased livers using hypothermic protection: preliminary results from the first 12 patients treated with this new technique. J. Am. Coll. Surg. 1996; 183 (6): 597-605. PMID: 8957462.
67.Miyazaki M., Ito H., Nakagawa K. Aggressive surgical resection for hepatic metastases involving the inferior vena cava. Am. J. Surg. 1999; 177 (4): 294-298. PMID: 10326846. doi: http://dx.doi.org/10.1016/S0002-9610(99)00044-6.
68.Morita S., Sakamoto M., Tateda T. Changes of stroke volume variation and central venous oxygen saturation during hepatectomy with clamping of portal triad and inferior vena cava-two case reports. St. Marianna Med. J. 2011; 39: 51-55.
69.Correa-Gallego C., Berman A., Denis S.C., Langdon-Embry L., O’Connor D., Arslan-Carlon V., Kingham T.P., D''Angelica M.I., Allen P.J., Fong Y., DeMatteo R.P., Jarnagin W.R., Melendez J., Fischer M. Renal function after low central venous pressureassisted liver resection: assessment of 2116 cases. H.P.B. 2015; 17: 258-264. doi: 10.1111/hpb.12347.
70.Wiggans M.G., Shahtahmassebi G., Bowles M.J., Aroori S., Stell D.A. Renal dysfunction is an independent risk factor for mortality after liver resection and the main determinant of outcome in posthepatectomy liver failure. H.P.B. Surg. 2013; 2013: 875367. Published online 2013 Nov 5. doi: 10.1155/2013/875367.
71.Kong R., Gao Y., Sun B. The strategy of combined ischemia preconditioning and salvianolic acid-B pretreatment to prevent hepatic ischemia-reperfusion injury in rats. Dig. Dis. Sci. 2009; 54 (12): 2568-2576. doi: 10.1007/s10620-008-0681-4.
72.Kilian W., Brost S., Steinebrunner N., Büchler M., Schemmer P., Müller М. Ischemia/reperfusion injury in liver surgery and transplantation: Pathophysiology. H.P.B. Surg. 2012; 2012: 176723. Published online 2012 May 30. doi: 10.1155/2012/176723.
73.Beck-Schimmer B., Breitenstein S., Urech S. A randomized controlled trial on pharmacological preconditioning in liver surgery using a volatile anesthetic. Ann. Surg. 2008; 248 (6): 909-916. doi: 10.1097/SLA.0b013e31818f3dda.
74.Zhao G., Ma H., Shen X., Xu G.F., Zhu Y.L., Chen B., Tie R., Qu P., Lv Y., Zhang H., Yu J. Role of glycogen synthase kinase 3β in protective effect of propofol against hepatic ischemiareperfusion injury. J. Surg. Res. 2013; 185 (1): 388-398. doi: 10.1016/j.jss.2013.05.004.
75.Giovanardi R.O., Rhoden E.L., Cerski C.T., Salvador M., Kalil A.N. Pharmacological preconditioning using intraportal infusion of L-arginine protects against hepatic ischemia reperfusion injury. J. Surg. Res. 2009; 155 (2): 244-253. doi: 10.1016/j.jss.2008.07.002.
76.Lai I.R., Chang K.J., Tsai H.W., Chen C.F. Pharmacological preconditioning with simvastatin protects liver from ischemia-reperfusion injury by heme oxygenase-1 induction. Transplantation. 2008; 85 (5): 732-738. doi: 10.1097/TP.0b013e3181664e70.
77.Poucke S.V., Stevens K., Marcus A.E., Lancé M. Hypothermia: effects on platelet function and hemostasis. Thrombosis Journal. 2014; 12: 31-35. doi: 10.1186/s12959-014-0031-z.
78.Jeppesen A.N., Kirkegaard H., Ilkjær S., Hvas A.М. Influence of temperature on thromboelastometry and platelet aggregation in cardiac arrest patients undergoing targeted temperature management. Critical Care. 2016; 20: 118-127. doi: 10.1186/s13054-016-1302-9.
79.Martini W.Z. Coagulopathy by hypothermia and acidosis: mechanisms of thrombin generation and fibrinogen availability. J. Trauma. 2009; 67 (1): 202-209. doi: 10.1097/TA.0b013e3181a602a7.
80.Tomimaru Y., Wada H., Marubashi S., Kobayashi S., Eguchi H., Takeda Y., Tanemura M., Noda T., Umeshita K., Doki Y., Mori M., Nagano H. Fresh frozen plasma transfusion does not affect outcomes following hepatic resection for hepatocellular carcinoma. World J. Gastroenterol. 2010; 16 (44): 5603-5610. PMID: 21105194.
81.Shiba H., Ishida Y., Fujiwara Y., Wakiyama S., Gocho T., Ito R., Sakamoto T., Tsutsui N., lida T., Matsumoto M., Furukawa K., Haruki K., Hirohara S., Misawa T., Yanaga K. Practice to minimize the use of blood products improve outcome after hepatic resection for hepatocellular carcinoma. Hepatogastroenterology. 2013; 60 (127): 1681-1683. PMID: 24634937.
82.Yamazaki S., Takayama T., Kimura Y., Moriguchi M., Higaki T., Nakayama H., Fujii M., Makuuchi M. Criteria for fresh frozen plasma in liver resection (A 3 + 3 Cohort Expansion Study). Arch. Surg. 2011; 146 (11): 1293-1299. doi: 10.1001/archsurg.2011.293.
83.Wong A.Y.C., Irwin М.G., Hui T.W.C., Fung S.K.Y., Fan S.T., Ma E.S.K. Desmopressin does not decrease blood loss and transfusion requirements in patients undergoing hepatectomy. Can. J. Anesth. 2003; 50 (1): 14-20. PMID: 12514144.
84.Ortmann E., Besser M.W., Klein A.A. Antifibrinolytic agents in current anaesthetic practice. Br. J. Anaesth. 2013; 111 (4

Anaesthesia Protocol to Extended Liver Resections: a Paradigm Shift under the Influence of the Experience of Liver Transplantation (Literature Review)

Belskiy V. A., Molkov A. M., Utkin I. A., Rabosina I. A., Zagainov V. E.

It is presented a review of current and the most relevant materials including evidence-based researches, guidelines, devoted to anesthesia during extended liver resections. Present algorithms of anesthesia were analyzed based on these data. It was noted significant differences in anesthetic approaches which are mainly explained by the problem of massive intraoperative blood loss. Expanding practice of liver transplantation is making significant adjustments to the carrying out of anesthesia during surgical intervention. Optimal algorithm of anestesia is determined based on the experience of extended liver resections and transplantations.

Keywords:
анестезия, печень, обширная резекция, мониторинг, инфузионная терапия, трансплантация, anesthesia, liver, extended liver resection, monitoring, infusion therapy, transplantation

ООО Издательский дом ВИДАР-М, 2016