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The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients

To evaluate the clinical effect of corrected left ventricular ejection time (LVETc) combined with dobutamine on the intraoperative management of patients undergoing hepatectomy for hepatocellular carcinoma. Sixty-eight patients with elective proposed pancreaticoduodenectomy, aged 61–78 years, body m...

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Autores principales: Jian, Yu, Xiaochen, Ji, Zongjian, Sun, Yu, Nie, Shiqiang, Shan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729562/
https://www.ncbi.nlm.nih.gov/pubmed/36476734
http://dx.doi.org/10.1038/s41598-022-24907-x
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author Jian, Yu
Xiaochen, Ji
Zongjian, Sun
Yu, Nie
Shiqiang, Shan
author_facet Jian, Yu
Xiaochen, Ji
Zongjian, Sun
Yu, Nie
Shiqiang, Shan
author_sort Jian, Yu
collection PubMed
description To evaluate the clinical effect of corrected left ventricular ejection time (LVETc) combined with dobutamine on the intraoperative management of patients undergoing hepatectomy for hepatocellular carcinoma. Sixty-eight patients with elective proposed pancreaticoduodenectomy, aged 61–78 years, body mass index 19–26 kg/m(2), and ASA classification II or III, were divided into two groups (n = 34) using the random number table method: the esophageal ultrasound group (S group) and the esophageal ultrasound combined with dobutamine group (D group). In both groups, an esophageal ultrasound probe was placed after induction of anesthesia, and the left ventricular ejection time (LVET) and stroke volume (SV) were measured via a long-axis section of gastric fundus to guide fluid infusion. Nitroglycerin or a combination of dobutamine and nitroglycerine were pumped intravenously from the beginning of surgery to the completion of hemostasis after partial hepatectomy, in groups S or D, respectively. Central Venous Pressure (CVP), heart rate HR, and mean arterial pressure MAP were recorded at entry (T(0)), immediately after induction (T(1)), at the beginning of the operation (T(2)), during hilar occlusion (T(3)), after partial hepatectomy (T(4)), and after the operation (T(5)). SV and LVETc were recorded between T(1) and T(5). At T(0) and T(5), blood samples from radial artery and central vein were taken to determine the concentration of blood lactic acid, and the oxygen supply index (DO(2)I) and oxygen uptake rate (O(2)ERe) were calculated by blood gas analysis. The operation time, hilar occlusion time, intraoperative urine volume, intraoperative crystalloid and colloid infusion, intraoperative blood loss and blood transfusion, and the occurrence of cardiac gas emboli during the operation were also recorded. Adverse events of cardiovascular, pulmonary, and renal function during and after operation were registered. Sixty-four patients were included in the final analysis. Compared with group S, group D had lower CVP values at T(2)–T(3) and higher SV values at T(2)–T(5), reduced intraoperative blood loss, significantly increased intraoperative urine output, a smaller total dose of nitroglycerin use, and lower incidences of intraoperative hypotension and cardiac gas emboli (P < 0.05). Esophageal ultrasound detection of LVETc combined with dobutamine ensures hemodynamic stability in patients undergoing partial hepatectomy while reducing the incidence of intraoperative hypotension and air embolism.
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spelling pubmed-97295622022-12-09 The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients Jian, Yu Xiaochen, Ji Zongjian, Sun Yu, Nie Shiqiang, Shan Sci Rep Article To evaluate the clinical effect of corrected left ventricular ejection time (LVETc) combined with dobutamine on the intraoperative management of patients undergoing hepatectomy for hepatocellular carcinoma. Sixty-eight patients with elective proposed pancreaticoduodenectomy, aged 61–78 years, body mass index 19–26 kg/m(2), and ASA classification II or III, were divided into two groups (n = 34) using the random number table method: the esophageal ultrasound group (S group) and the esophageal ultrasound combined with dobutamine group (D group). In both groups, an esophageal ultrasound probe was placed after induction of anesthesia, and the left ventricular ejection time (LVET) and stroke volume (SV) were measured via a long-axis section of gastric fundus to guide fluid infusion. Nitroglycerin or a combination of dobutamine and nitroglycerine were pumped intravenously from the beginning of surgery to the completion of hemostasis after partial hepatectomy, in groups S or D, respectively. Central Venous Pressure (CVP), heart rate HR, and mean arterial pressure MAP were recorded at entry (T(0)), immediately after induction (T(1)), at the beginning of the operation (T(2)), during hilar occlusion (T(3)), after partial hepatectomy (T(4)), and after the operation (T(5)). SV and LVETc were recorded between T(1) and T(5). At T(0) and T(5), blood samples from radial artery and central vein were taken to determine the concentration of blood lactic acid, and the oxygen supply index (DO(2)I) and oxygen uptake rate (O(2)ERe) were calculated by blood gas analysis. The operation time, hilar occlusion time, intraoperative urine volume, intraoperative crystalloid and colloid infusion, intraoperative blood loss and blood transfusion, and the occurrence of cardiac gas emboli during the operation were also recorded. Adverse events of cardiovascular, pulmonary, and renal function during and after operation were registered. Sixty-four patients were included in the final analysis. Compared with group S, group D had lower CVP values at T(2)–T(3) and higher SV values at T(2)–T(5), reduced intraoperative blood loss, significantly increased intraoperative urine output, a smaller total dose of nitroglycerin use, and lower incidences of intraoperative hypotension and cardiac gas emboli (P < 0.05). Esophageal ultrasound detection of LVETc combined with dobutamine ensures hemodynamic stability in patients undergoing partial hepatectomy while reducing the incidence of intraoperative hypotension and air embolism. Nature Publishing Group UK 2022-12-07 /pmc/articles/PMC9729562/ /pubmed/36476734 http://dx.doi.org/10.1038/s41598-022-24907-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Jian, Yu
Xiaochen, Ji
Zongjian, Sun
Yu, Nie
Shiqiang, Shan
The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients
title The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients
title_full The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients
title_fullStr The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients
title_full_unstemmed The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients
title_short The impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients
title_sort impacts of corrected left ventricular ejection time combined with dobutamine on hepatocellular carcinoma patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729562/
https://www.ncbi.nlm.nih.gov/pubmed/36476734
http://dx.doi.org/10.1038/s41598-022-24907-x
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