Perioperative Intra- and Extravascular Volume in Liver Transplant Recipients

Costa, M. G.; Girardi, Leonard N.; Pompei, Livia; Chiarandini, P.; Flaviis, Adelisa De; Lugano, Manuela; Mattelig, S.; Tripi, G.; Vetrugno, Luigi; Baccarani, Umberto; Scudeller, Luigia; Rocca, Giorgio Della

doi:10.1016/j.transproceed.2011.03.022

Cited by 11 publications

(3 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Costa et al. [1] also performed a study to compare PAC and PiCCO 2 following OLT, and they emphasized that parameters obtained using PiCCO 2 were much better indicators than CVP and pulmonary artery occlusion pressure. The PiCCO 2 system is a monitor that can continuously calculate CO with pulse‐counter analysis, after the first transpulmonary (transaortic) thermodilution‐mediated CO calculation and calibration.…”

Section: Discussionsupporting

confidence: 91%

“…Hyperdynamic circulation due to high cardiac output (CO), low systemic vascular resistance, and relative hypovolemia occur in cirrhotic patients undergoing orthotopic liver transplantation (OLT) [1,2]. The patients encounter major cardiovascular changes during OLT as a consequence of surgical bleeding, vena cava cross clamping, and reperfusion.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of pleth variability index as a predictor of fluid responsiveness during orthotopic liver transplantation

Konur

Kayhan

Toprak

et al. 2016

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

Fluid management is challenging and still remains controversial in orthotopic liver transplantation (OLT). The pleth variability index (PVI) has been shown to be a reliable predictor of fluid responsiveness of perioperative and critically ill patients; however, it has not been evaluated in OLT. This study was designed to examine whether the PVI can reliably predict fluid responsiveness in OLT and to compare PVI with other hemodynamic indexes that are measured using the PiCCO2 monitoring system. Twenty-five patients were enrolled in this study. Each patient was monitored using the noninvasive Masimo and PiCCO2 monitoring system. PVI was obtained with a Masimo pulse oximeter. Cardiac index was obtained using a transpulmonary thermodilution technique (CITPTD). Stroke volume variation (SVV), pulse pressure variation, and systemic vascular resistance index were measured using the PiCCO2 system. Fluid loading (10 mL/kg colloid) was performed at two different phases during the operation, and fluid responsiveness was defined as an increase in CITPTD ≥ 15%. During the dissection phase and the anhepatic phase, respectively, 14 patients (56%) and 18 patients (75%) were classified as responders. There were no differences between the baseline values of the PVI of responders and nonresponders. Area under the curve for PVI was 0.56 (sensitivity 35%, specificity 90%, p = 0.58) at dissection phase, and was 0.55 (sensitivity 55%, specificity 66%, p = 0.58) at anhepatic phase. Of the parameters, a higher area under the curve value was found for SVV. We conclude that PVI was unable to predict fluid responsiveness with sufficient accuracy in patients undergoing OLT, but the SVV parameter was reliable.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Evaluation of pleth variability index as a predictor of fluid responsiveness during orthotopic liver transplantation

Konur

Kayhan

Toprak

et al. 2016

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

show abstract

“…Indications for OLT in children include; Extrahepatic cholestasis, intrahepatic cholestasis, metabolic disorders, acute liver failure, and primary liver malignancy [1] . Cirrhosis and portal hypertension are the most significant changes in these patients, which can be seen as abnormalities in the cardiovascular system: hyperdynamic circulation symptoms, increasing cardiac output (CO), decreasing systemic vascular resistance (SVR), and elevated MAP [2] . Hypovolemia, hemorrhage, major vessel manipulations, and reperfusion should be evaluated with cardiovascular monitoring [3] .…”

Section: Introductionmentioning

confidence: 99%

Pulse Contour Cardiac Output System Monitoring in Pediatric Patients Undergoing Orthotopic Liver Transplantation

Ersoy

Ozdemirkan²,

Zeyneloğlu³

et al. 2022

ijirms

View full text Add to dashboard Cite

Background: This study aimed to demonstrate that PiCCO monitoring can be early guidance for fluid monitoring and hemodynamic parameter analysis in the pediatric OLT population. Method: A single-centre, retrospective cohort study in pediatric patients who underwent OLT between September 2014 and October 2017. Results: Forty-one pediatric patients (aged 4 months to 17 years) underwent hemodynamic monitoring with PiCCO during OLT. Measurements including mean arterial pressure (MAP), central venous pressure (CVP) and cardiac index (CI) were significantly lower during the Tanhepatic phase when compared to Tbaseline and Tnewhepatic phases (p<0.05 for all). Among the patients whose mean of Tnewhepetic extravascular lung water index (EVLWI) measurements were more excellent than 7 mL/kg; more significant amounts of intraoperative blood transfused (p=0.027), higher graft recipient body weight ratio (GRWR) (p=0.016) and longer anesthesia times (p=0.046) were seen. The mean of Tnewhepatic stroke volume variability (SVV) measurements was greater than 10% in patients with a higher GRWR (p=0.033). More blood transfusion was needed and a higher GRWR was observed in patients with a global end-diastolic volume index (GEDVI)<650 ml/m2 (p=0.000). The patients with a mean of Tnewhepatic CI measurements less than 3 L/min/m2 received more colloid transfusion and had longer anesthesia time during OLT. There was a statistically significant relationship between cell-saver/kg use and hospitalisation (p=0.008), and an association between urine output and mortality (p=0.024). Conclusion: PiCCO monitoring provides flow and dynamic parameters which predict fluid responsiveness and make critical therapeutic decisions to restore hemodynamic stability in pediatric patients undergoing OLT.

show abstract

Volumetric Parameters: A Physiological Background

Kuzkov

2021

Advanced Hemodynamic Monitoring: Basics and New Horizons

View full text Add to dashboard Cite

Perioperative Intra- and Extravascular Volume in Liver Transplant Recipients

Cited by 11 publications

References 18 publications

Evaluation of pleth variability index as a predictor of fluid responsiveness during orthotopic liver transplantation

Evaluation of pleth variability index as a predictor of fluid responsiveness during orthotopic liver transplantation

Pulse Contour Cardiac Output System Monitoring in Pediatric Patients Undergoing Orthotopic Liver Transplantation

Volumetric Parameters: A Physiological Background

Contact Info

Product

Resources

About