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  Česky / Czech version Rozhl. Chir., 2004, roč. 83, č. 9, s. 436-442.
 
A Model of Acute Hepatic Failure in a Minipig. Surgical and Anaesthesiological Points of View 
Ryska M., Kieslichová E.*, Pantoflíček T., Ryska O., Zazula R.*, Skibová J. 

Chirurgické oddělení UVN, Praha, primář prof. MUDr. M. Ryska, CS. Klinika anesteziologie, resuscitace a intenzivní péče IKEM, Praha, přednosta MUDr. E. Kieslichová
 


Summary:

       Aim: The aim of this study was to create an easily reproducible model of the acute hepatic failure (ASJ) in a minipig, which may allow to test supporting eliminating systems. The aim of this report was to describe the surgical technique with the anaesthesiological procedure and to demonstrate the experimental results on a group of the laboratory animals. Methodology: The ASJ was mocked using surgical devascularization of the liver: a ligature of the a. hepatica propria and v. portae, creating a portocaval anastomosis end-to-side. The animals were analgosedated during the experiment and were on a ventilatory support. Biochemical indicators of the hepatic failure, the ICP and the haemodynamics parameters were monitored. Hypoglycaemia with levels below 3.5 mmol/l and any increase of the intracranial pressure (ICP) were considered the onset of the hepatic failure. Material: 20 minipigs weighing 25–30 kg and divided in 3 groups, were included in the experiment: I – 10 animals were assigned to the acute hepatic failure (ASJ) group, II – 5 animals with the mock acute hepatic failure (ASJ), whose ICP was monitored in conjunction with the standard monitoring and III. 5 animals without the acute hepatic failure (ASJ) – a control group. Results: We proved significant differences in the AST levels (33.44 ± 39.96 vs. 1.56 ± 0.50 mmol/l), the lactate levels (2.97 ± 1.16 vs. 1.18 ± 0.61 mmol/l), and the ammonium levels (264.3 ± 93.05 vs. 42.5 ± 12.98 mol/l) in the acute hepatic failure (ASJ) group compared with the control group (p < 0.01) 6 hours after the surgery and significant changes in the glycaemia levels and the intracranial pressure (ICP) measurements 4 hours after the surgical procedure. Increase in the pulse frequency, the blood pressure, decrease of the mean arterial pressure (MAP) and decrease in the systemic venous resistence index (SVRI) in the acute hepatic failure (ASJ) group was recorded 6 hours after the procedure compared with the initial findings, with significant differences between the acute hepatic failure (ASJ groups and the control group as late as during the 12th hour following the procedure (SVRI: 953 ASJ vs. 1658 control, p _ 0.05, MAP: 58.1 ASJ vs. 76 control, p _ 0.05). No statistically significant differences in the heart index between the acute hepatic failure (ASJ) group and the control group were recorded. The animals with the acute hepatic failure (ASJ) survived 13 hours following the surgical procedure, on average.

        Key words: acute hepatic failure – surgical model in a minipig – haemodynamical parameters – intracranial pressure
       

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