Skip Navigation



BJA Advance Access published online on June 11, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh195
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
93/2/204    most recent
aeh195v1
Right arrow E-Letters: Submit a response to the article
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Choukèr, A.
Right arrow Articles by Thiel, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Choukèr, A.
Right arrow Articles by Thiel, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Accepted March 1, 2004

Clinical Investigation

Effects of Pringle manoeuvre and ischaemic preconditioning on haemodynamic stability in patients undergoing elective hepatectomy: a randomized trial

A. Choukèr 1, T. Schachtner 1, R. Schauer 2, M. Dugas 3, F. Löhe 2, A. Martignoni 1, B. Pollwein 1, M. Niklas 1, H. G. Rau 2, K. W. Jauch 2, K. Peter 1, M. Thiel 1*

1 Clinic of Anaesthesiology, Klinikum Grosshadern, Ludwig-Maximilians-University, D-81377 Munich, Germany
2 Department of Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University, D-81377 Munich, Germany
3 Institute for Epidemiology and Biometry, Klinikum Grosshadern, Ludwig-Maximilians-University, D-81377 Munich, Germany

* To whom correspondence should be addressed. E-mail: mthiel{at}med.uni-muenchen.de.


  Abstract

Background. The Pringle manoeuvre and ischaemic preconditioning are applied to prevent blood loss and ischaemia-reperfusion injury, respectively, during liver surgery. In this prospective clinical trial we report on the intraoperative haemodynamic effects of the Pringle manoeuvre alone or in combination with ischaemic preconditioning.

Methods. Patients (n=68) were assigned randomly to three groups: (i) resection with the Pringle manoeuvre; (ii) with ischaemic preconditioning before the Pringle manoeuvre for resection; (iii) without pedicle clamping.

Results. Following the Pringle manoeuvre the mean arterial pressure increased transiently, but significantly decreased after unclamping as a result of peripheral vasodilation. Ischaemic preconditioning improved cardiovascular stability by lowering the need for catecholamines after liver reperfusion without affecting the blood sparing benefits of the Pringle manoeuvre. In addition, ischaemic preconditioning protected against reperfusion-induced tissue injury.

Conclusions. Ischaemic preconditioning provides both better intraoperative haemodynamic stability and anti-ischaemic effects thereby allowing us to take full advantage of blood loss reduction by the Pringle manoeuvre.

Keywords: Keywords: arterial pressure; liver, ischaemia reperfusion; surgery, liver resection; surgery, portal triad clamping (Pringle manoeuvre)


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Physiol. Rev.Home page
B. Vollmar and M. D. Menger
The Hepatic Microcirculation: Mechanistic Contributions and Therapeutic Targets in Liver Injury and Repair
Physiol Rev, October 1, 2009; 89(4): 1269 - 1339.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
S. R. Walsh, T. Tang, U. Sadat, D. P. Dutka, and M. E. Gaunt
Cardioprotection by remote ischaemic preconditioning
Br. J. Anaesth., November 1, 2007; 99(5): 611 - 616.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Pathol.Home page
M. Massip-Salcedo, A. Casillas-Ramirez, R. Franco-Gou, R. Bartrons, I. Ben Mosbah, A. Serafin, J. Rosello-Catafau, and C. Peralta
Heat Shock Proteins and Mitogen-activated Protein Kinases in Steatotic Livers Undergoing Ischemia-Reperfusion: Some Answers
Am. J. Pathol., May 1, 2006; 168(5): 1474 - 1485.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.