Serum Lactate in Liver Resection Surgery. A Mini-Review
Intermittent Pringle maneuver (PM), i.e. temporary clamping of the hepatic hilum, has been pointed out as safe and useful for reducing blood loss during liver resection, but it exposes the patient the risk of ischemia-reperfusion liver injury. Serum lactate (sLac) concentration depends on the balance between production and clearance from the blood stream, and it has been reported to be a predictor of outcome in critically ill patients, including those with liver failure, sepsis and trauma.The patients undergoing to liver resection differ from critically ill patients, but this type of hepatic surgery may be somehow compared with critical illness, as major surgery causes a certain degree of Systemic Inflammatory Reaction Syndrome (SIRS). In such operations, postoperative acidosis may be mainly due both to high level of serum chloride (in case of large amount of NaCl 0.9% saline solution administered intra-operatively) and to hyperlactatemia. We reviewed the most recent Literature about this issue, in particular into the field of hepatic resection surgery.