Monitoring hepatic venous hemoglobin oxygen saturation in patients undergoing liver surgery

Hepatic venous oxygen saturation (Shv(O₂)) was continuously monitored in 33 consecutive patients undergoing hepatic lobectomy. Fiberoptic pulmonary artery catheters were inserted into the hepatic vein (HV) and in the pulmonary artery through the right internal jugular vein before anesthetic induction. The success rate and mean time for HV catheterization were 100% and 14 min, respectively. The only complication of the procedure was nonsustained atrial or ventricular arrhythmias. Eighteen patients showed decreases in Shv(O₂) to less than 30% at skin incision, at temporary cessation of hepatic inflow, and/or at surgical manipulation of the liver. Clinical HV catheterization was easy to accomplish and may be a valuable technique in studying the extent and significance of hepatic ischemia during liver surgery.