Changes in acid–base balance during electrolytic ablation in an ex vivo perfused liver model

Abstract Background Electrolytic ablation (EA) destroys tissues through extreme pH changes in the local microenvironment. An ex vivo perfused liver model was used to assess the systemic effects of EA on the acid–base balance without the influence of compensatory organs (lungs and kidneys). Methods E...

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Bibliographic Details
Published in:The American journal of surgery 2012-11, Vol.204 (5), p.666-670
Main Authors: Gravante, Gianpiero, M.D., Ph.D, Ong, Seok Ling, M.D, Metcalfe, Matthew S., M.D, Sorge, Roberto, Ph.D, Fox, Andrew J., M.D, Lloyd, David M., M.D, Maddern, Guy J, Dennison, Ashley R., M.D
Format: Article
Language:English
Subjects:
Ablation Techniques - methods
Acid base
Acid-Base Equilibrium
Animals
Bicarbonates - blood
Biological and medical sciences
Biomarkers - blood
Carbon Dioxide - blood
Electrodes
Electrolysis
Electrolytic ablation
Ex vivo
Experiments
Female
Fixed rates
General aspects
Hydrogen-Ion Concentration
In Vitro Techniques
Ischemia
Lactates - blood
Liver
Liver - surgery
Medical sciences
Surgery
Swine
Veins & arteries
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Summary:Abstract Background Electrolytic ablation (EA) destroys tissues through extreme pH changes in the local microenvironment. An ex vivo perfused liver model was used to assess the systemic effects of EA on the acid–base balance without the influence of compensatory organs (lungs and kidneys). Methods Eleven pigs were perfused extracorporeally at 39°C with autologous blood; 4 also underwent EA after 1 hour of reperfusion. Arterial blood samples were obtained hourly. Results pH and CO2 levels did not change throughout the experiments. A significant increase of HCO3 -, anion gap, base excess, and lactate was present after the third hour. No differences were observed between EA experiments and controls. Conclusions EA does not alter the acid–base balance even when the confounding influence of compensatory organs is removed. Such findings should be considered when planning ablations in patients with renal failure or respiratory diseases in which EA could avoid undesirable metabolic changes.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2009.12.019