How do the 2022 <scp>European Society of Cardiology</scp>/<scp>European Respiratory Society</scp> guidelines modify the diagnosis of <scp>portopulmonary hypertension</scp> in patients with cirrhosis complicated by portal hypertension? A post hoc analysis

Atsukawa, Masanori; Tsubota, Akihito; Tamura, Yuichi; Koyano‐Shioda, Kaori; Kawano, Tadamichi; Okubo, Tomomi; Hayama, Korenobu; Arai, Taeang; Itokawa, Norio; Taniguchi, Yu; Tamura, Yudai; Kondo, Chisa; Iwakiri, Katsuhiko

doi:10.1002/jgh3.12949

Cited by 2 publications

(1 citation statement)

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“…The PAC can differentiate portopulmonary hypertension (PoPH) from other causes of pulmonary hypertension [8 ▪ ,13]. PoPH occurs in about 5–10% of liver transplantation recipients and is associated with poor prognosis [6,17,42,45,77]. A mean PAP of more than 50 mmHg before skin incision is an indication for case cancellation [1 ▪▪ ,42,45].…”

Section: Pulmonary Artery Cathetermentioning

confidence: 99%

Hemodynamic monitoring in liver transplantation ‘the hemodynamic system’

Kandil,

Sedra

2023

Current Opinion in Organ Transplantation

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Purpose of review The purpose of this article is to provide a comprehensive review of hemodynamic monitoring in liver transplantation. Recent findings Radial arterial blood pressure monitoring underestimates the aortic root arterial blood pressure and causes excessive vasopressor and worse outcomes. Brachial and femoral artery monitoring is well tolerated and should be considered in critically ill patients expected to be on high dose pressors. The pulmonary artery catheter is the gold standard of hemodynamic monitoring and is still widely used in liver transplantation; however, it is a highly invasive monitor with potential for serious complications and most of its data can be obtained by other less invasive monitors. Rescue transesophageal echocardiography relies on few simple views and should be available as a standby to manage sudden hemodynamic instability. Risk of esophageal bleeding from transesophageal echocardiography in liver transplantation is the same as in other patient populations. The arterial pulse waveform analysis based cardiac output devices are minimally invasive and have the advantage of real-time beat to beat monitoring of cardiac output. No hemodynamic monitor can improve clinical outcomes unless integrated into a goal-directed hemodynamic therapy. The hemodynamic monitoring technique should be tailored to the patient's medical status, surgical technique, and the anesthesiologist's level of expertise. Summary The current article provides a review of the current hemodynamic monitoring systems and their integration in goal-directed hemodynamic therapy.

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Section: Pulmonary Artery Cathetermentioning

confidence: 99%