Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient
Lactic acidosis (LA) in end-stage liver disease (ESLD) patients has been recognized as one of the most complicated clinical problems and is associated with increased morbidity and mortality. Multiple-organ failure, associated with advanced stages of cirrhosis, exacerbates dysfunction of numerous par...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2017-04-01
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| Series: | The Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1515/jccm-2017-0014 |
| _version_ | 1797421773934821376 |
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| author | Vitin Alexander A. Azamfirei Leonard Tomescu Dana Lang John D. |
| author_facet | Vitin Alexander A. Azamfirei Leonard Tomescu Dana Lang John D. |
| author_sort | Vitin Alexander A. |
| collection | DOAJ |
| description | Lactic acidosis (LA) in end-stage liver disease (ESLD) patients has been recognized as one of the most complicated clinical problems and is associated with increased morbidity and mortality. Multiple-organ failure, associated with advanced stages of cirrhosis, exacerbates dysfunction of numerous parts of lactate metabolism cycle, which manifests as increased lactate production and impaired clearance, leading to severe LA-induced acidemia. These problems become especially prominent in ESLD patients, that undergo partial hepatectomy and, particularly, liver transplantation. Perioperative management of LA and associated severe acidemia is an inseparable part of anesthesia, post-operative and critical care for this category of patients, presenting a wide variety of challenges. In this review, lactic acidosis applied pathophysiology, clinical implications for ESLD patients, diagnosis, role of intraoperative factors, such as anesthesia- and surgery-related, vasoactive agents impact, and also current treatment options and modalities have been discussed. |
| first_indexed | 2024-03-09T07:22:14Z |
| format | Article |
| id | doaj.art-bf0b33e433de4368a918fc872343acc6 |
| institution | Directory Open Access Journal |
| issn | 2393-1817 |
| language | English |
| last_indexed | 2024-03-09T07:22:14Z |
| publishDate | 2017-04-01 |
| publisher | Sciendo |
| record_format | Article |
| series | The Journal of Critical Care Medicine |
| spelling | doaj.art-bf0b33e433de4368a918fc872343acc62023-12-03T07:16:48ZengSciendoThe Journal of Critical Care Medicine2393-18172017-04-0132556210.1515/jccm-2017-0014jccm-2017-0014Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease PatientVitin Alexander A.0Azamfirei Leonard1Tomescu Dana2Lang John D.3Department of Anesthesiology & Pain Medicine University of Washington Medical Center, Department of Surgery, Transplant Surgery Division, P.O.Box 356540 1959 NE Pacific street, Seattle WA, 98195, United States of AmericaUniversity of Medicine and Pharmacy of Tîrgu Mureș, Tîrgu Mureș, Romania“Carol Davila” University of Medicine and Pharmacy, Anesthesiology and Intensive Care Department 3, Fundeni Clinical Institute, Bucharest, RomaniaDepartment of Anesthesiology & Pain, Medicine University of Washington Medical Center, Seattle WA, United States of AmericaLactic acidosis (LA) in end-stage liver disease (ESLD) patients has been recognized as one of the most complicated clinical problems and is associated with increased morbidity and mortality. Multiple-organ failure, associated with advanced stages of cirrhosis, exacerbates dysfunction of numerous parts of lactate metabolism cycle, which manifests as increased lactate production and impaired clearance, leading to severe LA-induced acidemia. These problems become especially prominent in ESLD patients, that undergo partial hepatectomy and, particularly, liver transplantation. Perioperative management of LA and associated severe acidemia is an inseparable part of anesthesia, post-operative and critical care for this category of patients, presenting a wide variety of challenges. In this review, lactic acidosis applied pathophysiology, clinical implications for ESLD patients, diagnosis, role of intraoperative factors, such as anesthesia- and surgery-related, vasoactive agents impact, and also current treatment options and modalities have been discussed.https://doi.org/10.1515/jccm-2017-0014lactic acidosisend-stage liver diseaseperioperative managementliver transplantation |
| spellingShingle | Vitin Alexander A. Azamfirei Leonard Tomescu Dana Lang John D. Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient The Journal of Critical Care Medicine lactic acidosis end-stage liver disease perioperative management liver transplantation |
| title | Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient |
| title_full | Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient |
| title_fullStr | Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient |
| title_full_unstemmed | Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient |
| title_short | Review. Perioperative Management of Lactic Acidosis in End-Stage Liver Disease Patient |
| title_sort | review perioperative management of lactic acidosis in end stage liver disease patient |
| topic | lactic acidosis end-stage liver disease perioperative management liver transplantation |
| url | https://doi.org/10.1515/jccm-2017-0014 |
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