Influence of critical hypotension on the development of postoperative hepatic failure

The article is devoted to the study of influence of critical hypotension on the development of postoperative hepatic failure. The results of treatment of 54 patients who had. anatomical and advanced anatomical resections of a liver were analyzed. Also the causes that lead to the postoperative hepatic failure such as volume of intraoperative blood loss, duration of intraoperative hypotension were analyzed. As the result of the analysis of obtained data on the influence of studied parameters (volume of blood loss, duration. of vascular isolation and presence of intraoperative hypotension) on the development of hepatic failure in postoperative period we supposed that the most unfavorable prognostic sign of its appearance is an episode of critical decrease of arterial pressure during the operation. Thus even at massive blood loss hepatic failure doesn't always appear, whereas critical intraoperative hypotension causes its development. Taking into consideration data on the state of central hemodynamics at the performing of anatomic resections of liver we determined main approaches to the infusion-transfusion therapy during excluding of liver from blood circulation for the prophylactics of its reperfusion injuries. It was established that prophylactics and timely correction of critical intraoperative hypotenstion that is the main factor of development of postoperative hepatic failure should be considered as the key moments of intraoperative protection of hepatocytes.

hepatic failure, resection of liver, hypotention

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