DOI: https://doi.org/10.22263/2312-4156.2019.3.52
Tachyla S.A.1, Lipnitski A.L.1, Marochkov A.V.1, Antipenko A.A.2, Borisov O.L.2, Livinskaya V.A.3
Integrative indicator of the state of hepatic arterial blood flow in patients with critical conditions
1Mogilev Regional Hospital, Mogilev, Republic of Belarus
2Mogilev State University named after A.A. Kuleshov, Mogilev, Republic of Belarus
3Belarusian-Russian University, Mogilev, Republic of Belarus
Vestnik VGMU. 2019;18(3):52-60.
Abstract.
Objectives. To develop and introduce into clinical practice an integrative index of hepatic arterial blood flow based on the tetrapolar rheohepatography (RHG) method in patients with obstructive jaundice, liver cirrhosis and multiple organ dysfunction syndrome (MODS) taking into account the assessment of their laboratory parameters.
Material and methods. 106 patients of the department of anesthesiology and resuscitation were included in a prospective cohort study (61 men and 45 women, mean age 61 (51-69) years, weight 80 (70-92) kg, height 170 (168-176) cm. All patients were divided into four groups: the 1st (control) – patients with fractures of the upper or lower extremities, somatically practically healthy (n=34); the 2nd – patients with obstructive jaundice (n=16); the 3rd – patients with cirrhosis of the liver (n=23); the 4th – patients with MODS (n=33). The results of the RHG and laboratory parameters were analyzed.
Results. We have developed an integrative indicator of the state of the hepatic arterial blood flow, which consists in determining the area under the arterial part of the RGH curve using the Stewart formula. In patients of the 1st group, the area under the RHG curve was 45.0 (38.9-50.9) mΩ * s. Patients of the 2nd group had no disturbances of the arterial hepatic blood flow (the area under the RHG curve was 44.0 (40.4-48.6) mΩ * s), despite the presence of hyperbilirubinemia and cytolysis signs. In patients of the 3rd and the 4th groups, the area under the RHG curve was significantly reduced and amounted to 11.2 (7.3–20.0) mΩ * s and 13.1 (8.4-30.1) mΩ * s, respectively. This was accompanied by laboratory signs of the impaired synthetic liver function.
Conclusions. The integrative index of hepatic arterial blood flow is an objective parameter of the RHG, which can be used in clinical practice for the rapid diagnosis of the state of hepatic blood flow at the patient’s bedside.
Key words: obstructive jaundice, cirrhosis of the liver, multiple organ dysfunction syndrome, hepatic blood flow, rapid diagnosis, rheohepatography.
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Information about authors:
Tachyla S.A. – Candidate of Medical Sciences, anesthesiologist-resuscitator of the anesthesiology & resuscitation department, Mogilev Regional Hospital,
ORCID: https://orcid.org/0000-0003-1659-5902
Lipnitski A.L. – Candidate of Medical Sciences, anesthesiologist-resuscitator, head of the department for taking organs and tissues for transplantation, Mogilev Regional Hospital,
ORCID: https://orcid.org/0000-0002-2556-4801
Marochkov A.V. – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator, Mogilev Regional Hospital,
ORCID: https://orcid.org/0000-0001-5092-8315
Antipenko A.A. – Candidate of Biological Sciences, associate professor of the Chair of Sports & Medicobiologic Disciplines, Mogilev State University named after A.A. Kuleshov;
Borisov O.L. – Candidate of Biological Sciences, associate professor, head of the Chair of Sports & Medicobiologic Disciplines, Mogilev State University named after A.A. Kuleshov,
Livinskaya V.A. – Candidate of Physical and Mathematical Sciences, associate professor of the Chair «Finance & Accounting», Belarusian – Russian University,
ORCID: https://orcid.org/0000-0001-8953-8533
Correspondence address: Republic of Belarus, 212016, Mogilev, 12 Belynitsky-Birula str., Mogilev Regional Hospital, the anesthesiology & resuscitation department. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Sergey A. Tachyla.
