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BJA Advance Access published online on March 19, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh112
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted December 8, 2003

Short Communication

Liver tissue partial pressure of oxygen and carbon dioxide during partial hepatectomy

A. J. Brooks 1, J. Eastwood 2, I. J. Beckingham 1, K. J. Girling 2*

1 Department of Surgery, Queen’s Medical Centre, University Hospital NHS Trust, Nottingham NG7 2UH, UK
2 Department of Critical Care, Queen’s Medical Centre, University Hospital NHS Trust, Nottingham NG7 2UH, UK

* To whom correspondence should be addressed. E-mail: keith.girling{at}nottingham.ac.uk.


  Abstract

Background. Data on tissue oxygen partial pressure (PtO2) and carbon dioxide partial pressure (PtCO2) in human liver tissue are limited. We set out to measure changes in liver PtO2 and PtCO2 during changes in ventilation and a 10 min period of ischaemia in patients undergoing liver resection using a multiple sensor (Paratrend® Diametrics Medical Ltd, High Wycombe, UK).

Methods. Liver tissue oxygenation was measured in anaesthetized patients undergoing liver resection using a sensor inserted under the liver capsule. PtO2 and PtCO2 were recorded with FIO2 values of 0.3 and 1.0, at end-tidal carbon dioxide partial pressures of 3.5 and 4.5 kPa and 10 min after the onset of liver ischaemia (Pringle manoeuvre).

Results. Data are expressed as median (interquartile range). Increasing the FIO2 from 0.3 to 1.0 resulted in the PtO2 changing from 4.1 (2.6-5.4) to 4.6 (3.8-5.2) kPa, but this was not significant. During the 10 min period of ischaemia PtCO2 increased significantly (P<0.05) from 6.7 (5.8-7.0) to 11.5 (9.7-15.3) kPa and PtO2 decreased, but not significantly, from 4.3 (3.5-12.0) to 3.3 (0.9-4.1) kPa.

Conclusion. PtO2 and PtCO2 were measured directly using a Paratrend® sensor in human liver tissue. During anaesthesia, changes in ventilation and liver blood flow caused predictable changes in PtCO2.

Keywords: Keywords: carbon dioxide, tissue; liver, ischaemia; monitoring, tissue; oxygen, tissue


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