Hepatic venous hemoglobin oxygen saturation predicts liver dysfunction after hepatectomy.

Abstract

A fiberoptic flow-directed catheter inserted into the hepatic vein continuously measures hepatic venous oxygen hemoglobin saturation (ShvO2). This study determined whether intraoperatively measured ShvO2 could predict postoperative serum activities of aminotransferases and patient outcome in 83 patients undergoing hepatectomy. The duration of intraoperative ShvO2 less than or equal to 10, 20, 30, 40, and 50% was calculated in each case. Significant increases in postoperative serum aminotransferases were associated with more than 1, 11, 31, 51, and 181 min of duration of ShvO2 less than or equal to 10, 20, 30, 40, and 50%, respectively. The incidence of postoperative liver failure significantly increased when the duration of ShvO2 less than or equal to 20, 30, and 40% exceeded 11, 31, and 51 min, respectively. The mortality from liver failure was significantly higher when the duration of ShvO2 less than or equal to 30 and 40% exceeded 31 and 51 min, respectively. Therefore, intraoperative monitoring of ShvO2 may predict not only the increase in postoperative serum aminotransferases but also patient outcome in terms of postoperative liver failure after hepatectomy.