Surgery of the Inferior Vena Cava by Daniel Azoulay Chetana Lim & Chady Salloum

Author:Daniel Azoulay, Chetana Lim & Chady Salloum
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

6.2.2 Hemodynamic Changes of the Caval Cross Clamping

Total vascular exclusion leads to a decrease of 10 % of blood pressure, 25 % of the pulmonary arterial pressure, 40 % of cardiac index, and 80 % of systemic vascular resistance [4, 5]. These hemodynamic changes are variable and depend on the volume of blood circulating and cardiac function of the patient. The inferior vena cava flow (3.5 l/min) contributes to 70 % of the total cardiac output (5 l/min). The remaining 30 % of the cardiac output comes from the superior vena cava. The inferior vena cava carries deoxygenated blood from the lower half of the body (abdomen, pelvis, and legs) into the right atrium of the heart. Inferior vena cava clamping has two consequences: (i) a significant decrease in venous return and an impaired cardiac output and (ii) clamping of the venous renal outflow and the venous drainage of the gastrointestinal tract that causes congestion of the kidney and the gastrointestinal tract. If the consequences of the infrahepatic inferior vena cava clamping are usually well tolerated, infrahepatic inferior vena cava clamping combined with suprahepatic inferior vena cava clamping induced much more marked hemodynamic consequences with a risk of cardiovascular collapse.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.