Systemic and regional effects of supraceliac aortic occlusion during experimental hepatic vascular exclusion

Background Supraceliac aortic occlusion (AO) has been recommended to avoid hypotension during hepatic vascular exclusion (HVE). We hypothesized that AO may negatively affect splanchnic perfusion during HVE. Methods Twenty-six dogs (16 ± 0.3 kg) were randomly assigned to HVE (n = 13) or HVE+AO (n = 13), during 30 minutes followed by a 60-minute reperfusion period. Cardiac output (CO), mean arterial pressure (MAP), superior mesenteric artery blood flow (SMABF, ultrasonic flowprobe), gastric mucosal PCO2 (gas tonometry) and PCO2-gap were evaluated. Results HVE alone induced decreases in MAP from 115 ± 5.1 to 26 ± 1 mm Hg, in CO from 2.0 ± 0.1 to 0.4 ± 0.1 L/min and SMABF from 398 ± 42 to 16 ± 7.6 mL/min, while PCO2 gap increased from 4 ± 3.7 to 52 ± 5.4 mm Hg. Supraceliac aortic occlusion only avoided severe hypotension. During reperfusion MAP, CO, and SMABF were partially restored, while PCO2 gap showed no improvements in either group. Conclusions HVE promotes major systemic and splanchnic perfusional derangement. Concomitant AO may avoid HVE-induced hypotension without producing further deleterious effects.