Pre- and postoperative systemic hemodynamic evaluation in patients subjected to esophagogastric devascularization plus splenectomy and distal splenorenal shunt: A comparative study in schistomomal portal hypertension

Table 1 Preoperative laboratory and arterial blood gases data

	Mean ± SD	Normal values
ALT (IU/L)	31.7 ± 16.8	7-45
AST (IU/L)	31.6 ± 20.5	7-45
Gamma GT (IU/L)	46.2 ± 25.5	7-50
ALP (IU/L)	118.5 ± 46.3	60-122
BUN (mg/dL)	25.5 ± 5.75	10-50
Cr (mg/dL)	0.78 ± 0.16	0.6-1.4
TP (g/dL)	7.45 ± 0.71	6-8
ALB (g/dL)	4.18 ± 0.48	3.5-5.0
PT (s)	14.2 ± 2.9	14 ± 2
PTT (s)	29.8 ± 6.26	30 ± 2
TBIL (mg%)	1.16 ± 0.73	1.4
IBIL (mg%)	0.79 ± 0.67	0.8
Hb (g/dL)	11.2 ± 2.4	12-18
Ht (%)	34.4 ± 7.2	36-54
WBC (103/mm3)	3.63 ± 2.2	4-10
PLT (103/mm3)	88.74 ± 56.24	150-400
pH	7.41 ± 0.05	7.37-7.44
pO2 (mmHg)	91.4 ± 6.5	80-100
pCO2 (mmHg)	34.9 ± 3.2	34-45
SaO2 (%)	97.1 ± 0.95	96-98

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; Gamma GT: Gamma glutamil transpeptidase; BUN: Blood urea nitrogen; Cr: Creatinine; PT: Prothrombin time; PTT: Partial thromboplastin time; Hb: Hemoglobin; Ht: Hematocrit; WBC: White blood cells; PLT: Platelets; pO₂: Arterial oxygen tension; PaCO₂: Arterial carbon dioxide tension; SaO₂: Arterial oxygen saturation; ALP: Alkaline phosphatase; TP: Total serum protein; ALB: Aalbumin; TBIL: Total serum bilirubin; IBIL: Indirect bilirubin.

Table 2 Preoperative transthoracic echocardiography in patients with portal hypertension due to hepatosplenic mansonic schistosomiasis

	Preop (mean ± SD)	Normal range
Ao	30.7 ± 1.9	20-35 mm
LA	38.1 ± 4.6	20-40 mm
LVDD	49.7 ± 3.9	35-55 mm
FDV	125.4 ± 29.6	50-150 mL
LVSD	30.9 ± 2.8	20-35 mm
SV	30.1 ± 8.1	50-150 mL
DD	37.6 ± 3.3	30%-40%
EF	75.9 ± 4.5	65%-80%
Se	8.9 ± 0.6	7-11 mm
Pw	8.4 ± 0.5	7-11 mm
V/M	65.1 ± 6.8	45%-75%

Ao: Aorta; LA: Left atrium; LVDD: Left ventricular diastolic diameter; FDV: Final diastolic volume; LVSD: Left ventricular systolic diameter; SV: Systolic volume; DD: Shortening fraction; EF: Ejection fraction; Se: Septum wall thickness; Pw: Left ventricular wall thickness; V/M: Left ventricular volume/mass relationship; E/A: Ratio between wave E and A.

Table 3 Pre- and postoperative hemodynamic parameters in patients with portal hypertension due to hepatosplenic mansonic schistosomiasis

	Preop	EGDS	DSRS	Normal values
HR	80.2 ± 11.4	83.1 ± 10.6	86.7 ± 17.9	80-100 beats/min
MABP	91.4 ± 12.5	93.6 ± 14.4	92.36 ± 13.75	80-100 mmHg
RAP	7.9 ± 2.5	7 ± 2.4	7.26 ± 2.4	0-7 mmHg
PCWP	10.2 ± 2.7	9.1 ± 3	9.55 ± 2	8-12 mmHg
PAP	18 ± 5.1	12.65 ± 4.7d	19.84 ± 5.2	12-15 mmHg
CI	4.78 ± 1.13	3.8 ± 0.4d	5.2 ± 0.76	2.5-4 L/min per m2
SI	60.24 ± 12.8	46.2 ± 8.6d	59.64 ± 10.5	41-51 mL/beat per m2
SVRI	1457 ± 380.7	1901.4 ± 330.2d	1389 ± 311	1970-2390 dynes.s/cm5.m2
PVRI	133 ± 62	141.65 ± 102.9	139.7 ± 67.8	225-315 dynes.s/cm5.m2
LCWI	6.14 ± 1.43	4.9 ± 0.7b	6.94 ± 1.3	3.4-4.2 kg.m/m2
LVSWI	76.6 ± 17.8	59 ± 12.6b	82.65 ± 17	50-62 g.m/m2
RCWI	1.22 ± 0.5	0.79 ± 0.4b	1.31 ± 0.35	0.54-0.60 kg.m/m2
RVSWI	15.25 ± 6.4	9.45 ± 4.8b	16.3 ± 6.3	7.9-9.7 g.m/m2

^bP < 0.01 between EGDS and PREOP;

^dP < 0.001 between EGDS and PREOP. Values are expressed as means ± SD. EGDS: Esophagogastric devascularization and splenectomy; DSRS: Distal splenorenal shunt; HR: Heart rate; MABP: Mean arterial blood pressure; PAP: Mean pulmonary artery pressure; RAP: Mean right atrium pressure; PCWP: Pulmonary capillary wedged pressure; CI: Cardiac index; SI: Systolic index; SVRI: Systemic vascular resistance index; PVRI: Pulmonary vascular resistance index; RCWI and LCWI: Right and left cardiac work indexes, LVSWI and RVSWI: Left and right ventricular systolic work indexes.