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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Beck, Christopher Schwartges, Ingo Picker, Olaf |
| Description | Country affiliation: Germany Author Affiliation: Beck C ( Department of Anaesthesiology, University Hospital Duesseldorf, Duesseldorf, Germany.) |
| Abstract | PURPOSE OF REVIEW: This review presents important pathophysiological alterations associated with impaired liver function and discusses protective perioperative strategies and the various anaesthetic agents recommended. RECENT FINDINGS: Perioperative liver impairment is a serious complication of anaesthesia and surgery. Unfortunately, clinicians are provided with only crude macrohaemodynamic monitoring devices to optimize their therapy. Technical improvements have revealed some complex mysteries of perioperative microcirculatory alterations and have disclosed a large heterogeneity between different vascular beds. The present review will critically discuss current clinical concepts of optimizing global haemodynamic variables and the often contrasting effects of vasoactive agents on the microcirculatory nutritional blood flow. Finally, promising protective experimental interventions of pharmacological or ischaemic preconditioning are presented and their often disillusioning transition into recent clinical trials is highlighted. SUMMARY: Targeted perioperative liver protection still lacks adequate monitoring tools and is currently based on optimization of global haemodynamic variables. While there is currently no evidence suggesting a positive effect of ischaemic preconditioning, promising experimental results of pharmacological preconditioning and therapeutic hypothermia require further evaluation in larger randomized clinical trials. |
| File Format | HTM / HTML |
| ISSN | 10705295 |
| Issue Number | 2 |
| Volume Number | 16 |
| e-ISSN | 15317072 |
| Journal | Current Opinion in Critical Care |
| Language | English |
| Publisher | Lippincott Williams & Wilkins |
| Publisher Date | 2010-04-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Critical Care Anesthesia Adverse Effects Hepatectomy Methods Intraoperative Complications Chemically Induced Liver Diseases Etiology Liver Surgery Anesthetics Humans Prevention & Control Pathology Liver Function Tests Journal Article Review |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine |
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