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SHS investigation development is considered from the geographical and historical viewpoint. 3 stages are described. Within Stage 1 the work was carried out in the Department of the Institute of Chemical Physics in Chernogolovka where the scientific discovery had been made. At Stage 2 the interest to SHS arose in different cities and towns of the former USSR. Within Stage 3 SHS entered the international scene. Now SHS processes and products are being studied in more than 50 countries.
Abstract
• Anesthetic management plays a key role in the reduction of perioperative causes of mortality in liver surgery, such as bleeding and liver failure.
• Intraoperative reduction of the hepatic blood flow can result from changes in blood volume status and also from mechanical or pharmacological effects, and can lead to liver dysfunction.
• Central venous pressure lower than 5mmHg reduces blood loss during hepatic parenchymal transection.
• Inhalational anesthetics such as sevoflurane, desflurane, and isoflurane can maintainor even increase total hepatic blood flow; meanwhile, intravenous anesthetics have a modest impact on that.
• Intraoperative fluid management should not be guided exclusively by central venous pressure, and the use of colloids (such as 5% albumin) as a maintenance and replacement solution reduces extravascular translocation of fluids.
• Pharmacological preconditioning, mainly with the use of inhaled anesthetics, has been used to prevent ischemia-reperfusion syndrome, although its pathophysiology is not entirely understood.
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Authors:Bentham Science Books