Development of severe lactic acidosis during radio frequency ablation conducted for the treatment of hepatocellular carcinomata in a patient with liver cirrhosis

Hiroaki Shiokawa, Takashi Akata, Jun Yoshino, Tadashi Kandabashi, Shosuke Takahashi

研究成果: ジャーナルへの寄稿記事

抄録

A 60-year-old male with liver cirrhosis (ChildPugh class B) underwent laparotomic radio frequency ablation for the treatment of a solitary hepatocellular carcinoma (-4.5 cm in diameter). Severe lactic acidosis (base excess<-12 mEq · l-1, lactate>150 mg · dl-1) developed during the intraoperative period, when neither his hemodynamics nor arterial oxygenation was significantly impaired. The blood loss was small (-200 g), and the serum hemoglobin level was maintained -10 g · dl-1 during the procedure. There was no evidence for impairment of either peripheral perfusion or renal function. In addition, there was no evidence for development of either splanchnic ischemia or diabetic ketoacidosis. Thus, the acidosis appeared to be caused by significant impairment of liver function possibly resulting from the ablation (total ablation time=-60 min). The core temperature increased rapidly (-1.5°C/60 hr) immediately after the ablation was started, suggesting that a large amount of heat was produced in the ablated area and/or that the vicinity of the ablated area was richly supplied by blood flow. As a result, intact liver cells in the vicinity of the tumor probably suffered from thermal injuries. In conclusion, depending on preoperative liver function, ablated area, and/or blood flow in the vicinity of ablated area, the ablation may become significantly invasive.

元の言語英語
ページ(範囲)1263-1267
ページ数5
ジャーナルJapanese Journal of Anesthesiology
51
発行部数11
出版物ステータス出版済み - 11 1 2002

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Lactic Acidosis
Radio
Liver Cirrhosis
Hepatocellular Carcinoma
Liver
Hot Temperature
Intraoperative Period
Diabetic Ketoacidosis
Viscera
Acidosis
Hemoglobins
Therapeutics
Ischemia
Perfusion
Hemodynamics
Kidney
Temperature
Wounds and Injuries
Serum
Neoplasms

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

これを引用

Development of severe lactic acidosis during radio frequency ablation conducted for the treatment of hepatocellular carcinomata in a patient with liver cirrhosis. / Shiokawa, Hiroaki; Akata, Takashi; Yoshino, Jun; Kandabashi, Tadashi; Takahashi, Shosuke.

:: Japanese Journal of Anesthesiology, 巻 51, 番号 11, 01.11.2002, p. 1263-1267.

研究成果: ジャーナルへの寄稿記事

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abstract = "A 60-year-old male with liver cirrhosis (ChildPugh class B) underwent laparotomic radio frequency ablation for the treatment of a solitary hepatocellular carcinoma (-4.5 cm in diameter). Severe lactic acidosis (base excess<-12 mEq · l-1, lactate>150 mg · dl-1) developed during the intraoperative period, when neither his hemodynamics nor arterial oxygenation was significantly impaired. The blood loss was small (-200 g), and the serum hemoglobin level was maintained -10 g · dl-1 during the procedure. There was no evidence for impairment of either peripheral perfusion or renal function. In addition, there was no evidence for development of either splanchnic ischemia or diabetic ketoacidosis. Thus, the acidosis appeared to be caused by significant impairment of liver function possibly resulting from the ablation (total ablation time=-60 min). The core temperature increased rapidly (-1.5°C/60 hr) immediately after the ablation was started, suggesting that a large amount of heat was produced in the ablated area and/or that the vicinity of the ablated area was richly supplied by blood flow. As a result, intact liver cells in the vicinity of the tumor probably suffered from thermal injuries. In conclusion, depending on preoperative liver function, ablated area, and/or blood flow in the vicinity of ablated area, the ablation may become significantly invasive.",
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AU - Akata, Takashi

AU - Yoshino, Jun

AU - Kandabashi, Tadashi

AU - Takahashi, Shosuke

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N2 - A 60-year-old male with liver cirrhosis (ChildPugh class B) underwent laparotomic radio frequency ablation for the treatment of a solitary hepatocellular carcinoma (-4.5 cm in diameter). Severe lactic acidosis (base excess<-12 mEq · l-1, lactate>150 mg · dl-1) developed during the intraoperative period, when neither his hemodynamics nor arterial oxygenation was significantly impaired. The blood loss was small (-200 g), and the serum hemoglobin level was maintained -10 g · dl-1 during the procedure. There was no evidence for impairment of either peripheral perfusion or renal function. In addition, there was no evidence for development of either splanchnic ischemia or diabetic ketoacidosis. Thus, the acidosis appeared to be caused by significant impairment of liver function possibly resulting from the ablation (total ablation time=-60 min). The core temperature increased rapidly (-1.5°C/60 hr) immediately after the ablation was started, suggesting that a large amount of heat was produced in the ablated area and/or that the vicinity of the ablated area was richly supplied by blood flow. As a result, intact liver cells in the vicinity of the tumor probably suffered from thermal injuries. In conclusion, depending on preoperative liver function, ablated area, and/or blood flow in the vicinity of ablated area, the ablation may become significantly invasive.

AB - A 60-year-old male with liver cirrhosis (ChildPugh class B) underwent laparotomic radio frequency ablation for the treatment of a solitary hepatocellular carcinoma (-4.5 cm in diameter). Severe lactic acidosis (base excess<-12 mEq · l-1, lactate>150 mg · dl-1) developed during the intraoperative period, when neither his hemodynamics nor arterial oxygenation was significantly impaired. The blood loss was small (-200 g), and the serum hemoglobin level was maintained -10 g · dl-1 during the procedure. There was no evidence for impairment of either peripheral perfusion or renal function. In addition, there was no evidence for development of either splanchnic ischemia or diabetic ketoacidosis. Thus, the acidosis appeared to be caused by significant impairment of liver function possibly resulting from the ablation (total ablation time=-60 min). The core temperature increased rapidly (-1.5°C/60 hr) immediately after the ablation was started, suggesting that a large amount of heat was produced in the ablated area and/or that the vicinity of the ablated area was richly supplied by blood flow. As a result, intact liver cells in the vicinity of the tumor probably suffered from thermal injuries. In conclusion, depending on preoperative liver function, ablated area, and/or blood flow in the vicinity of ablated area, the ablation may become significantly invasive.

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