RÉSUMÉ
The Orthotopic liver transplantation for the terminal liver diseases has been performed frequently since the introduction of new immuno-suppressive agent (cyclosporin A), technical advances in surgical skill, uae of biopump during anhephatic stage, rapid infusion system for transfusion and thromboelastography for coagulopathies were used. In Korea, only one case of orthotopic liver transplantation succeeded in 1988, but the animal experiments have been going on for many years in many institutes. Orthotopic liver transplantation in dogs using centrifugal pump (Bio-pump) were experienced and the results were analysed; 1) There were no differences in hemodynamic parameters during anhepatic stage with assistance of Biopump compared with preanhephatic stage. 2) The mean flow rate of Biopump during anhepatic stage was 0.75+/-0.09L/min, and maximun and minimum flow rate were 1.5L/min. and 0.4L/min, respectively. 3) Mean artery pressure, cardiac output and systemic vascular resistance after reperfusion of transplanted liver were significantly reduced compared with the values of before reperfusion; meanwhile, mean pulmonary artery pressure, pulmonary capillary wedge pressure and pulmonary vascular resistance were not significantly different. 4) After reperfusion of transplanted liver serum potassium level was significantly increased to 6. 07+/-1.8 mEq/L and the amount of base was significantly decrease to-12.9+/-5.9 mEq/L. By using Bio-pump the degree of hemodynamic changes could be reduced during the clamping of inferior vena cava and hepatic vein.
Sujet(s)
Animaux , Chiens , Académies et instituts , Expérimentation animale , Artères , Débit cardiaque , Constriction , Hémodynamique , Veines hépatiques , Corée , Maladies du foie , Transplantation hépatique , Foie , Potassium , Artère pulmonaire , Pression artérielle pulmonaire d'occlusion , Reperfusion , Thromboélastographie , Résistance vasculaire , Veine cave inférieureRÉSUMÉ
Perioperative hypothermia can occur rather frequently with in varying degree and lead to the various complications. Because infants, small children, elderly patient, cachetic patient and multiple trauma patients are prone to develop hypothermia during the operation and anesthesia. An anesthesiologist should be aware of deveolpment of hypothermia and take appropriate measures to prevent it. Authors experienced a case of hypothermia with body temperature dropped 32.4degrees C during the reconstruction of retrognathism and temporo-mandibular joint release in 6-year-old female child. Appropriate measures were taken for hypothermia, and the patient was discharged without any complication.