Biliary Atresia
Conditions
Brief summary
To evaluate the effects of sevoflurane on hepatic blood flow (HBF) and hepatic arterial buffer response (HABR) in infants with obstructive jaundice by Doppler ultrasound.Twenty-five infants with biliary atresia (1-3 months-of-age) scheduled for a Kasai procedure were enrolled. portal vein blood flow (PBF), hepatic arterial blood flow (HABF) and hepatic blood flow (HBF) were measured by Doppler ultrasound before induction, and after inhalation of 2 and 3% sevoflurane.
Detailed description
Children suffering from hepatobiliary disease also have an hepatic arterial buffer response (HABR) with reduced portal vein blood flow (PBF) and compensatory increases in hepatic arterial blood flow (HABF) which can help maintain hepatic blood flow (HBF). For infants with obstructive hepatobiliary disease, reduced HBF may affect drug metabolism and increase the risk of respiratory depression during analgesia, which can be life-threatening. To evaluate the effects of sevoflurane on HBF and HABR in infants with obstructive jaundice by Doppler ultrasound.Twenty-five infants with biliary atresia (1-3 months-of-age) scheduled for a Kasai procedure were enrolled. PBF, HABF and HBF were measured by Doppler ultrasound before induction, and after inhalation of 2 and 3% sevoflurane.
Interventions
DRUGSevoflurane
general anesthesia with 2% followed by 3% sevoflurane
Sponsors
Children's Hospital of Fudan University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Months to 3 Months
Healthy volunteers
No
Inclusion criteria
* persistent yellow skin or sclera, pale stool (in severe cases, clay-like), and hepatomegaly; * increased serum bilirubin (progressively or no decline after increase), increased total bilirubin (TBil) dominated by increased direct bilirubin (DBil) (\>60%); * elevated liver enzymes; * ultrasound confirmation of poor gallbladder filling and signs of liver fibrosis; * with radionuclide imaging confirmation of obstructed biliary excretion
Exclusion criteria
* concomitant cardiovascular or abdominal organ malformations
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| portal blood flow | 10 minutes |
| hepatic arterial blood flow | 10 minutes |
| hepatic blood flow | 10 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| blood pressure | 5 minutes | noninvasive blood pressure |
| renal blood flow | 10 minutes | — |
| femoral vein blood flow | 10 minutes | — |
Outcome results
None listed