Anest. intenziv. Med. 2004;15(2):81-83

Anaesthesia Management of Extended Liver Resection without Allogenic Blood Transfusion: a Case ReportArticles

R. Gál¹, I. Čundrle¹, B. Stibor¹, Z. Kala¹, V. Procházka²

¹ Anesteziologicko-resuscitační oddělení, Fakultní nemocnice Brno, primář doc. MUDr. I. Čundrle, CSc.

² Chirurgická klinika, Fakultní nemocnice Brno, přednosta prof. MUDr. J. Vomela, CSc.

We report anaesthesia management for liver resection in a patient with supposedlarge blood loss,because of close relationsof the hepatic metastasis of colorectal carcinoma to the portal and inferior caval vein. To minimize blood loss we usedcombination of an acute normovolemic haemodilution (ANH) and a low central venous pressure (CVP) anaesthesia. The2000 g of whole blood was withdrawnafter induction of general anaesthesia.TheCVPwas maintained below5mmHg duringresection of hepatic parenchyma. The right hepatectomy with subsegmentomy IV A was performed using of total vascularexclusion.The estimated blood loss was 2000 ml.The patient was extubated withoutcomplications the first day after surgerywith haematocrit value 0.35 and haemoglobin level 113 g/dl. Except application of antithrombin III (1000 units) there was nonecessity to administrate another allogenic blood products.

Keywords: hepatic resection; low CVP anaesthesia; acute normovolemic haemodilution

Published: April 1, 2004  Show citation