[Cardiorespiratory dynamics following hepatic resection]

The cardiorespiratory dynamics following hepatic resection was investigated with the use of Swan-Ganz catheter in 34 patients with major hepatic resection. In the patients without cirrhosis or jaundice, cardiac index (CI) appeared to decrease with increased systemic vascular resistance (SVR) during the first postoperative day. CI tended to increase on the second or third postoperative day with normal SVR. In the majority of the patients without hepatic cirrhosis or jaundice who underwent more than 50% hepatectomy the circulating blood volume decreased immediately after the operation and increased after the second postoperative day. In the cirrhotic patients, hyperdynamic state was noted pre- and post-operatively, and was prominent in the cases with poor prognosis. These patients had relatively higher pulmonary arterial and wedge pressure, and were liable to yield to cardiorespiratory insufficiency by overhydration. In the jaundiced patients, the patterns of hemodynamic change were similar to those of the patients without cirrhosis or jaundice except for decreased SVR. The jaundiced patients did not develop severe respiratory distress in spite of having lower PO2 and higher AaDO2.