Smalbroek, B. (Bo) (2017) Impaired oxygenation of the liver in biliary atresia: An explorative study. thesis, Medicine.
Full text available on request.Abstract
Biliary atresia is a disease that is characterized by inflammation, obliteration and fibrosis of the extrahepatic bile ducts. It used to be a fatal disease, but after thirty years a Kasai portoenterostomy or liver transplantation are now available as treatment. The etiology is presumed to be multifactorial and many possible factors are already identified, such as infectious, toxic, genetic and vascular components. There are hypoxic factors present in the livers of BA patients that indicating a vascular etiology plays a role, but there has never been proven that these patients actually do have a lower liver oxygenation. This study measured the cerebral and liver oxygenation simultaneously through Near Infrared Spectroscopy (NIRS) measurements in BA patients and pyloric hypertrophy patients (control group). Cerebral oxygenation (ScO2) and liver oxygenation (SlO2) of both groups were measured and these values were compared. Significantly lower SlO2 values (P=.02) and ScO2 values (P=.01) were found in the BA patients. However, since ΔTOI was not significant (P=.589), we can conclude that the oxygenation of the liver stays intact during the early stages of BA. We cannot confirm the indications of previous studies that an impaired oxygenation is present in biliary atresia. Elevated levels of conjugated bilirubin seemed to cause the lower tissue oxygenation levels in BA patients. This has implications on the use of NIRS in neonatal jaundice, because this study concludes that NIRS can always be used in patients with unconjugated jaundice. The study population needs to be expanded to confirm the findings of this explorative study.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty/daily supervisor: and Hulscher, J.B.F. MD and Dep. Of Pediatric Surgery University Medical Centre Groninge |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/487 |
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