影响肝细胞癌患者肝移植后肿瘤复发及预后的相关因素

目的分析影响肝细胞癌（HCC）患者肝移植后肿瘤复发和预后的相关因素，总结HCC患者肝移植的选择标准。方法回顾性分析118例HCC肝移植受者的临床资料，应用单因素和多因素的分析方法，分析临床和病理等相关因素对HCC患者肝移植后肿瘤复发及预后的影响，筛选出影响肿瘤复发和预后的危险因素，并结合国际HCC肝移植受者选择标准运用于临床。结果HCC患者肝移植围手术期死亡8例，对存活的110例随访1～32个月，其中有41例肿瘤复发（37．3％），死亡39例（35．5％）；12、18和24个月的累积存活率分别是84．55％、70．30％和62．24％；12、18和24个月的无瘤存活率分别是69．05％、66．93％和61．38％。单因素分析结果显示癌栓形成、米兰标准、肿瘤大小、肿瘤分化程度以及pTNM分期对HCE患者肝移植后肿瘤复发有显著影响；癌栓形成、米兰标准、术前血清甲胎蛋白（AFP）水平、肿瘤分化程度以及pTNM分期对患者预后有显著影响；多因素分析显示，癌栓形成和肿瘤分化程度是肿瘤复发的独立影响因素，癌栓形成和术前AFP水平则是影响预后的独立危险因素。结论癌栓形成和肿瘤分化程度是影响HCC患者肝移植后肿瘤复发的独立因素，而癌栓形成和术前AFP水平是影响预后的独立危险因素。     

影响肝移植治疗肝细胞癌预后的相关因素分析

目的 探讨影响肝移植治疗肝细胞癌(HCC)预后的相关因素.方法 回顾性分析2004年8月至2011年2月间147例HCC患者接受肝移植治疗的临床资料.单因素分析共纳入14个指标:受者性别、年龄、血型、术前肝功能分级、终末期肝病模型评分、甲胎蛋白(AFP)水平、肿瘤数目、肝脏被肿瘤取代率、是否侵犯左右叶、累计肿瘤直径、是否侵犯肝包膜、大血管受侵犯、微血管受侵犯(MVI)以及HCC组织学分级.将差异有统计学意义的指标纳入Cox风险比例模型行多因素分析,筛选出独立危险因素.结果 143例受者获得完整随访,随访时间6～84个月,术后1、3年总体存活率分别为75.2％和54.7％,无瘤存活率分别为70％和59％.单因素分析显示,受者年龄、AFP水平、肿瘤数目、累计肿瘤直径、肝脏被肿瘤取代率、侵犯左右叶、侵犯肝包膜、大血管受侵犯、MVI等指标的差异有统计学意义(P＜0.05);经多因素分析,MVI、大血管受侵犯和AFP≥400μg/L是影响HCC患者肝移植术后存活率的独立危险因素.结论 MVI、大血管受侵犯、AFP是影响HCC肝移植术后存活率的主要危险因素,肝移植术前对其进行适当干预,术中严格按照无瘤技术操作,可明显改善预后.     

影响原发性肝癌肝移植治疗的预后因素分析

目的分析影响肝癌肝移植术后生存率和无瘤生存率的危险因素，探讨国内肝移植治疗肝癌的选择标准。方法对67例接受同种异位原位肝移植治疗的原发性肝癌病人的基本资料和肿瘤相关资料包括术前病情分级、血清AFP水平、术前辅助治疗以及肝癌大小、数目、pTNM分期、肿瘤恶性程度分级等因素进行单因素和多因素分析。结果术后1年、2年累积生存率为77％、67％，6个月和12个月无瘤生存率为66％和58％。单因素分析显示对肝癌肝移植术后累积生存率影响有统计学意义的因素为CHILD分级（MELD积分）和肝外大血管侵犯；多因素分析影响肝癌肝移植术后无瘤生存率有统计学义的因素是肿瘤大小、大血管侵犯和肿瘤分化程度。结论影响肝癌肝移植术后生存率的因素仍是术前患者肝功能状态。对存在大血管侵犯的肝癌患者需严格控制肝移植术适应证，而无血管侵犯的患者在选择肝移植治疗时肿瘤大小指标可较米兰标准适当放宽。     

肝癌肝移植疗效评价及预后多因素分析

目的 评价肝移植治疗原发性肝癌的疗效,并分析影响预后的因素。方法 回顾性分析2001年12月至2006年12月第二军医大学附属长征医院肝移植科234例肝癌肝移植病人的临床资料。用SPSS11.0软件进行统计分析,用Kaplan-Meier法计算累计和无瘤存活率,Log-rank检验和Cox回归模型分别进行预后单、多因素分析。结果 全组随访1～56个月,随访期间死亡85例(36.3%),复发70例 (29.9%)。术后6个月及1、2、3、4年累计存活率分别为88.5%及76.3%、61.3%、53.6%、47.6%;6个月及1、2、3年无瘤存活率分别为80.1%及70.6%、60.4%、52.3%。单因素分析显示：术前肝功能Child-Pugh分级、术前甲胎蛋白（AFP）水平、肿瘤类型、肿瘤大小、淋巴结转移、大血管侵犯、肿瘤分化程度和TNM分期与预后有关;Cox回归多因素分析显示：术前AFP水平、肿瘤类型、大血管侵犯和肿瘤分化程度是影响预后的独立因素。结论 肝移植是治疗原发性肝癌的有效方法,经严格筛选的适宜受体预后良好。     

影响原发性肝癌肝移植治疗的预后因素分析

目的分析影响肝癌肝移植术后生存率和无瘤生存率的危险因素,探讨国内肝移植治疗肝癌的选择标准。方法对67例接受同种异位原位肝移植治疗的原发性肝癌病人的基本资料和肿瘤相关资料包括术前病情分级、血清AFP水平、术前辅助治疗以及肝癌大小、数目、pTNM分期、肿瘤恶性程度分级等因素进行单因素和多因素分析。结果术后1年、2年累积生存率为77%、67%,6个月和12个月无瘤生存率为66%和58%。单因素分析显示对肝癌肝移植术后累积生存率影响有统计学意义的因素为CHILD分级(MELD积分)和肝外大血管侵犯;多因素分析影响肝癌肝移植术后无瘤生存率有统计学义的因素是肿瘤大小、大血管侵犯和肿瘤分化程度。结论影响肝癌肝移植术后生存率的因素仍是术前患者肝功能状态。对存在大血管侵犯的肝癌患者需严格控制肝移植术适应证,而无血管侵犯的患者在选择肝移植治疗时肿瘤大小指标可较米兰标准适当放宽。     

微血管侵犯对肝癌肝移植受者预后影响的临床研究

目的  探讨微血管侵犯（MVI）对原发性肝癌（肝癌）肝移植受者预后的影响。方法  回顾性分析177例肝癌肝移植受者的临床资料,根据术后病理学检查结果分为MVI阳性组（64例）和MVI阴性组（113例）。比较MVI阴性组和MVI阳性组受者的临床资料;分析肝癌肝移植受者的预后及危险因素。结果  177例受者中,64例（36.2%）MVI阳性,113例（63.8%）MVI阴性。与MVI阴性受者相比,MVI阳性受者的肿瘤分化程度低、术前甲胎蛋白（AFP）水平高、肿瘤最大直径大、肿瘤数量多、伴卫星灶多、不符合米兰标准的例数多（均为P < 0.05）。肝癌肝移植受者1、3、5年累积生存率（OS）和无复发生存率（RFS）分别为80.2%、62.1%、58.5%和66.3%、57.5%、51.2%。MVI阳性受者的1、3、5年OS和RFS分别为70%、39%、35%和53%、39%、33%,低于MVI阴性受者的86%、75%、72%和73%、68%、63%,差异均有统计学意义（均为P < 0.05）。Cox回归分析结果显示,肿瘤最大直径>8 cm、术前AFP水平≥20 ng/mL、肿瘤中低分化和MVI阳性是影响肝癌肝移植受者OS的独立危险因素（均为P < 0.05）,MVI阳性、肿瘤中低分化以及术前未降期成功是影响肝癌肝移植受者RFS的独立危险因素（均为P < 0.05）。结论  MVI对预测肝癌肝移植受者的预后具有重要的临床价值。     

肝癌肝移植生存情况及预后影响因素分析（附109例报告）

目的了解原发性肝细胞癌（肝癌）患者肝移植术后的生存情况,探讨影响其预后的危险因素。方法回顾性分析2004年1月至2007年12月中山大学附属第三医院肝移植中心的109例肝癌肝移植病例的临床资料。应用Kaplan-Meier法计算累积生存率和无瘤生存率,采用Log-rank检验和Cox回归模型分别进行无瘤生存率单因素、多因素分析。结果 109例肝癌肝移植患者中,37例肿瘤复发,占总数的33.9%,复发时间2～25（中位时间8）个月。全部病例1年、3年、5年累积生存率分别为86.9%、66.1%、56.6%,而1年、3年、5年无瘤生存率分别为78.3%、64.7%、53.1%。单因素分析显示,影响肝癌肝移植术后无瘤生存率的危险因素有肿瘤大小、肿瘤侵犯血管及病理分化程度。Cox风险回归模型多因素分析发现,肿瘤侵犯血管及病理分化程度是影响肝癌肝移植患者术后无瘤生存率的独立危险因素（均为P〈0.05）。结论影响肝癌肝移植患者术后无瘤生存率的独立危险因素是术前肿瘤侵犯血管和术后病理肿瘤分化程度,应严格筛选肝癌肝移植的适应证可有效降低术后肿瘤的复发率。     

影响原发性肝癌患者肝移植预后的危险因素分析

目的 评价肝移植对原发性肝癌的疗效，探讨影响预后的危险因素。方法 回顾性分析1999年1月至2005年12月间872例原发性肝癌患者行首次肝移植后的生存情况，应用单因素分析和多因素Cox回归分析各项临床及病理指标对预后的影响。结果 围手术期死亡率为3．9％；移植术后6个月、1年、2年、3年及4年累积生存率分别为87．3％、74．4％、63．3％、53．8％和48．4％；术后6个月、1年、2年及3年无瘤生存率分别为80．6％、68．9％、58．5％和52．6％；再次移植率为2．8％。多因素Cox回归分析发现，影响术后累积生存率的独立危险因素包括患者术前甲胎蛋白水平（Х^2=16．732，P=0．001）、肿瘤双叶分布（RR=7．274，P=0．007）、门静脉主干或分支癌栓（RR=4．349，P=0．034）及镜下微血管浸润（RR=10．162，P=0．002）；影响术后无瘤生存率的独立危险因素包括肿瘤双叶分布（RR=2．969，P=0．047）、门静脉主干或分支癌栓（RR=2．496，P=0．025）、镜下微血管浸润（RR=10．115，P=0．020）及合并淋巴结侵犯或远处转移（RR=4．750，P=0．013）。结论 肝移植是治疗原发性肝癌的有效方法，经严格筛选的适宜受者预后良好。     

肝细胞癌临床病理学特征与手术后长期存活的多因素相关分析

目的评估肝细胞癌（hepatocellular carcinoma，HCC）病理学特征对于长期存活的影响。方法选取1991年1月至2002年6月西南医院实施根治性肝切除，具有完整随访资料和临床资料234例HCC，应用COX比例风险模型单因素和多因素分析影响预后的病理因素，寿命表法计算生存率，Kaplan-Meier乘积极限法绘制生存曲线，log-rank Χ^2检验比较生存时间差异。结果单因素分析提示影响HCC预后的病理因素包括肿瘤大小、微血管侵犯、大血管侵犯、淋巴结侵犯、邻近器官侵犯和Edmonson-Steiner分级，多因素分析发现大血管侵犯（RR：1．728，P〈0．05）、微血管侵犯（RR：1．476，P〈0．05）、淋巴结侵犯（RR：5．010，P〈0．01）、邻近器官侵犯（RR：1．695，P〈0．05）是独立影响HCC预后的重要病理因素。结论大血管侵犯、微血管侵犯、淋巴结侵犯、邻近器官侵犯是影响HCC预后的重要病理学因素。     

术前外周血AFP表达水平与肝癌肝移植患者生存率的关系

目的探讨原发性肝癌肝移植患者术前外周血AFP表达水平与生存率的关系。方法回顾性分析我科2001年12月~2006年12月间234例肝癌肝移植患者的临床资料,按术前外周血AFP表达水平分为3组:A组:AFP<20μg/L,B组:AFP<400μg/L,C组:AFP≥400μg/L,用SPSS11.0软件进行统计分析,Kaplan-Meier法计算累积/无瘤生存率,Long-ran法检验组间差异,Cox模型进行预后多因素分析。结果全组随访1~56个月,随访期间死亡85例(36.3%),复发70例(29.9%)。患者6个月、1、2、3、4年累积生存率分别为88.5%、76.3%、61.3%、53.6%、47.6%;6个月、1、2、3年无瘤生存率分别为80.1%、70.6%、60.4%、52.3%。A、B两组患者6个月、1、2、3、4年累积/无瘤存活率均明显高于C组(P<0.05),而两组之间差异无显著性(P>0.05);Cox回归多因素分析显示:术前AFP水平、肿瘤类型、大血管侵犯和肿瘤分化程度是影响预后的独立因素。结论术前外周血AFP表达水平是肿瘤复发和影响患者生存的危险因素,可作为预后的判断因子。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.