CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Anest. intenziv. Med., 15, 2004, č. 2, s. 81–83. |
Anaesthesia Management of Extended Liver Resection without Allogenic Blood Transfusion:
a Case Report Gál R.1, Čundrle I.1, Stibor B.1, Kala Z.1, Procházka V.2 1Anesteziologicko-resuscitační oddělení, Fakultní nemocnice Brno, primář doc. MUDr. I. Čundrle, CSc. 2Chirurgická klinika, Fakultní nemocnice Brno, přednosta prof. MUDr. J. Vomela, CSc. |
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Summary: We report anaesthesia management for liver resection in a patient with supposedlarge blood loss,because of close relations
of the hepatic metastasis of colorectal carcinoma to the portal and inferior caval vein. To minimize blood loss we used
combination of an acute normovolemic haemodilution (ANH) and a low central venous pressure (CVP) anaesthesia. The
2000 g of whole blood was withdrawnafter induction of general anaesthesia.TheCVPwas maintained below5mmHg during
resection of hepatic parenchyma. The right hepatectomy with subsegmentomy IV A was performed using of total vascular
exclusion.The estimated blood loss was 2000 ml.The patient was extubated withoutcomplications the first day after surgery
with haematocrit value 0.35 and haemoglobin level 113 g/dl. Except application of antithrombin III (1000 units) there was no
necessity to administrate another allogenic blood products.
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