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A clinical study on the mechamism and early diagnosis of acute liver dysfunction following cardiac surgery.

Research Project

Project/Area Number 62570636
Research Category

Grant-in-Aid for General Scientific Research (C)

Allocation TypeSingle-year Grants
Research Field Thoracic surgery
Research InstitutionOsaka University

Principal Investigator

MATSUDA Hikaru  Osaka University Medical School (Assistant Professor), 医学部, 講師 (00028614)

Co-Investigator(Kenkyū-buntansha) 大久保 修和  大阪大学, 医学部附属病院, 医員
OHTANI Masakatsu  Osaka University Medical School (Research Assistant), 医学部, 助手 (90168980)
NAKANO Susumu  Osaka University Medical School (Assistant Professor), 医学部, 講師 (70028653)
OHKUBO Nobukazu  Osaka University Medical School (Resident)
Project Period (FY) 1987 – 1988
Project Status Completed (Fiscal Year 1988)
Budget Amount *help
¥2,100,000 (Direct Cost: ¥2,100,000)
Fiscal Year 1988: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1987: ¥1,800,000 (Direct Cost: ¥1,800,000)
KeywordsCardiac Surgery / Liver Dysfunction / Hepatic Venous Oxygen Saturation / 肝静脈カテーテル
Research Abstract

Acute liver dysfunction (ALD) is one of the major complications after cardiac surgery. To elucidate the mechanism of ALD following cardiac surgery and to establish useful predictor for ALD, we introduced hepatic venous oxygen saturation (ShvO_2) monitoring to the patients who underwent cardiac surgery.
In 37 patients: 17 with congenital and 20 with acquired heart disease, ShvO_2 was measured for 1-4 days postoperatively. The mean ShvO_2 value for 24 hours around the lowest point (m-ShvO_2) was compared with the postoperative results of liver functions, hepatic lactate metabolism and hemodynamics. The results were as follows:
1. m-ShvO_2 ranged from 5% to 79% with the average of 44%.
2. In 14 patients with m-ShvO_2 <30%, 11 patients developed ALD with serum alanine aminotransferase (ALT) >100 U/l (the highest value: 4,050 U/l) or serum total bilirubin (TB)>3.0mg/dl (the highest: 11.5 mg/dl), and there were significant inverse correlations between m-ShvO_2 and the highest value of blood chemistry (ALT, GLDH, T-Bil). In 23 patients with m-ShvO_2>40%, the liver function indices stayed within almost normal ranges without significant correlations to m-ShvO_2.
3. In 14 patients with m-ShvO_2 <30%, there was a significant inverse correlation between m-ShvO_2 and hepatic venous lactate pyruvate ratio.
4. m-ShvO_2 showed significant relation to mixed venous oxygen saturation (SvO_2) and CVP in multivariate analysis.
5. In pre, peri and postoperative factors, m-ShvO_2 most significantly contributed to ALD-score in multivariate analysis.
In conclusion, significant decrease in ShvO_2 as below 30% appears to indicate hepatic tissue hypoxia causing ALD from hepatic hypoperfusion with resultant from systemic hypoperfusion and high CVP. And ShvO_2 monitoring may be useful to predict the development of ALD in critical patients after cardiac surgery.

Report

(3 results)
  • 1988 Annual Research Report   Final Research Report Summary
  • 1987 Final Research Report Summary

Research Products

(19 results)

All Other

All Publications (19 results)

  • [Publications] Matsuda H;Covino E;Hirose H;Nakano S;Kishimoto H;Miyamoto Y;Nishigaki K;Takano H;Ohtake S;Sakaki S;Ogawa M;Taenaka N;Kawashimay Y: Journal of Thoracic and Cardiovascular Surgery. 96. 219-226 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Matsuda H;Takano H;Nakano S;Shirakura R;Ohtani M;Taniguchi K;Miyamoto Y;Ohtake S;Sawa Y;Tenaka N;Kawashima Y: Japanese Circulation Journal. 53. 175-179 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 松田暉,広瀬一,島崎靖久,谷口和博,西垣恭一,榊成彦,高野弘志,小川寛,妙中信之,川島康生: 日本胸部外科学会雑誌. 36. 1135-1141 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 高野弘志,松田暉,大谷正勝,谷口和博,大竹重彰,広瀬一,川島康生: 日本外科学会雑誌. 88. 1513- (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 高野弘志,松田暉,中埜粛,酒井敬,大谷正勝,川口章,大竹重彰,松若良介,宮川周士,新谷英夫,井上智勝,川島康生: 人工臓器. 18. 435-439 (1989)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 高野弘志,松田暉,大谷正勝,谷口和博,大竹重彰,広瀬一,川島康生: 日本心臓血管外科学会雑誌. 17. 657-659 (1988)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Matsuda, H.; Covino, E.; Hirose, H.; Nakano, S.; Kishimoto, H.; Miyamoto, Y.; Nishigaki, K., et al.: "Acute liver dysfunction after modified Fontan operation for complex cardiac lesions." Journal of Thoracic and Cardiovascular Surgery. 96. 219-226 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Matsuda, H.; Takano, H.; Nakano, S.; Shirakura, R.; Ohtani, M.; Taniguchi, K.; Miyamoto, Y., et al.: "Analysis of acute and chronic heart failure in view of hepatic oxygen supply-demand relationship using hepatic venous oxygen saturation." Japanese Circulation Journal. 53. 175-179 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Takano, H.; Matsuda, H.; Ohtani, M.; Taniguchi, K.; Ohtake, S.; Hirose, H.; Kawashima, Y.: "A clinical study using hepatic vein catheterization on the mechanism for acute liver dysfunction following open heart surgery." Nippon Geka Gakkai Zasshi. 88. 1513 (1987)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] Takano, H.; Matsuda, H.; Nakano, S.; Sakai, K.; Ohtani, M.; Kawaguchi, A.; Ohtake, S.; Matsuwaka, R., et al.: "Hepatic venous oxygen saturation monitoring in patients undegoing assisted circulation." The Japanese Journal of Artificial Organs. 18. 435-439 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1988 Final Research Report Summary
  • [Publications] 高野弘志,松田暉,大谷正勝,谷口和博,大竹重彰,広瀬一,川島康生: 日本外科学会雑誌. 88. 1513 (1987)

    • Related Report
      1988 Annual Research Report
  • [Publications] 松田暉,広瀬一,島崎靖久,谷口和博,西垣恭一,柳成彦,高野弘志,小川実,妙中信之,川島康生: 日本胸部外科学会雑誌. 36. 1135-1141 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 高野弘志,松田暉,大谷正勝,谷口和博,大竹重彰,広瀬一,川島康生: 日本心臓血管外科学会雑紙. 17. 657-659 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] Matsuda,H.;Covino,E.;Hirose,H.;Nakano,S.;Kishimoto,H.;Miyamoto,Y.;Nishigaki,K.;Takano,H.;Ohtake,S.,et al.: J.Thorac.Cardiovase Surg.96. 219-226 (1988)

    • Related Report
      1988 Annual Research Report
  • [Publications] 高野弘志,松田暉,中埜粛,酒井敬,大谷正勝,川口章,大竹重彰,松若良介,宮川周士,新谷英夫,井上智勝,川島康生: 人工臓器. 18. 435-439 (1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] Matsuda,H.;Takano,H.,et al.: Jap.Circ.J.(1989)

    • Related Report
      1988 Annual Research Report
  • [Publications] 高野弘志: 日本外科学会雑誌. 88. 1513- (1987)

    • Related Report
      1987 Final Research Report Summary
  • [Publications] 松田暉: 日本胸部外科学会雑誌.

    • Related Report
      1987 Final Research Report Summary
  • [Publications] 高野弘志: 日本心臓血管外科学会雑誌.

    • Related Report
      1987 Final Research Report Summary

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Published: 1987-03-31   Modified: 2016-04-21  

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