Korean Journal of Radiology

  • 제11권6호
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  • Pages.640-647
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  • 2010
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Case Study of Hepatic Radiofrequency Ablation Causing a Systemic Inflammatory Response Under Total Intravenous Anesthesia

  • Schalte, Gereon (Department of Anesthesiology, University Hospital, RWTH Aachen) ;
  • Henzler, Dietrich (Department of Anesthesiology and Division of Critical Care, Queen Elisabeth II Health Sciences Center & Dalhousie University) ;
  • Waning, Christian (Department of Anesthesiology, University Hospital, RWTH Aachen) ;
  • Tacke, Josef (Department of Diagnostic and Interventional Radiology, Klinikum Passau) ;
  • Rossaint, Rolf (Department of Anesthesiology, University Hospital, RWTH Aachen) ;
  • Mahnken, Andreas H. (Department of Diagnostic and Interventional Radiology, University Hospital)
  • 투고 : 2010.07.07
  • 심사 : 2010.08.06
  • 발행 : 2010.12.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To investigate the effects of hepatic radiofrequency ablation (RFA) in patients with malignant liver disease with respect to inflammation activation and stress response. Materials and Methods: In an observational trial, we investigated the physiologic parameters of 17 patients (20 interventions) who underwent percutaneous RFA under general anesthesia after applying total intravenous anesthesia. $TNF{\alpha}$, IL-6, IL-8, IL-10, adrenaline and noradrenaline, liver enzymes, lactate and creatine kinase were determined pre-interventionally after induction of anesthesia (T1), 90 minutes after initiation of RFA (T2), immediately after the conclusion of the procedure (T3), and 24 hours after the procedure (T4). Results: A significant increase in body temperature (p < 0.001), and mean arterial pressure (p = 0.001) were measured intraoperatively (T2) and the day after the procedure (T4). Increased levels of IL-6 were measured at T3 and T4 (p = 0.001). IL-10 increased immediately after the procedure (T3; p = 0.007). IL-6 levels correlated well with the total energy applied (r = 0.837). Significant increases in the levels of adrenaline and noradrenaline were present at T3 and T4 (p < 0.001). The RFA-induced destruction of hepatic tissue was associated with increased levels of AST, ALT, GLDH and LDH. Conclusion: Percutaneous RFA of hepatic malignancies causes an inflammatory and endocrine activation, similar to the systemic inflammatory response syndrome. These effects have to be taken in account when dealing with patients susceptible to sepsis or multi-organ failure.

키워드

참고문헌

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  2. Factors related to postoperative pain among patients who underwent radiofrequency ablation of hepatocellular carcinoma vol.68, pp.6, 2013, https://doi.org/10.1016/j.crad.2012.12.006
  3. Profound systemic inflammatory response syndrome following non-emergent intestinal surgery in children vol.48, pp.9, 2013, https://doi.org/10.1016/j.jpedsurg.2013.05.065
  4. US-guided high-intensity focused ultrasound (HIFU) of abdominal tumors: outcome, early ablation-related laboratory changes and inflammatory reaction. A single-center experience from Germany vol.38, pp.2, 2021, https://doi.org/10.1080/02656736.2021.1900926