The Gastroenterology Suite and TIPS

Kelhoffer, Eric R.; Osborn, Irene P.

doi:10.1097/00004311-200341020-00007

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Gastrointestinal endoscopy [18] Common procedures performed in this location include endoscopic retrograde cholangiopancreaticography (ERCP), upper gastrointestinal endoscopy and colonoscopy. Risks commonly associated with these procedures are shown in Table 5.…”

Section: Methodsmentioning

confidence: 99%

“…In deciding the optimal anesthetic, the anesthesiologist has to consider the urgency of the procedure, the severity of the underlying medical condition of the patient (especially the systemic manifestations of the hepatic dysfunction), the effect of the hepatic dysfunction on the available anesthetic drugs and if the patient is in the most optimal medical condition for the planned anesthetic. Some patients may require paracentesis prior to the procedure to improve respiration [18].…”

Section: Interventional Radiologymentioning

confidence: 99%

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Closed claims review of anesthesia for procedures outside the operating room

Robbertze

Posner

Domino

2006

Current Opinion in Anaesthesiology

134

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Section: Methodsmentioning

confidence: 99%

Section: Interventional Radiologymentioning

confidence: 99%

Closed claims review of anesthesia for procedures outside the operating room

Robbertze

Posner

Domino

2006

Current Opinion in Anaesthesiology

134

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Transjugular intrahepatic portosystemic shunt (TIPS): the anesthesiological point of view after 150 procedures managed under total intravenous anesthesia

DeGasperi

Corti

Corso

et al. 2009

J Clin Monit Comput

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TIPS is a percutaneous procedure which diverts blood from the portal to the systemic circulation preventing rebleeding from varices and stopping or reducing the formation of ascites. The choice of the anaesthetic technique is still a matter of debate. Since January 2003, 150 consecutive TIPS were performed using total intravenous anesthesia (TIVA), (propofol/fentanyl or remifentanil), endotracheal intubation and mechanical ventilation. Sixty-one patients were classified as ASA 2, 73 ASA 3, and 16 ASA 4. According to CHILD classification, 96 patients were in Class A, 48 in Class B, 6 in Class C. Mean duration f the procedure was 100+/-62 min. After TIPS placement Portal vein pressure decreased from 30+/-10 to 14+/-4 mmHg while RAP increased from 8+/-4 to 12+/-6 mmHg. Intraoperative fluid management included mainly crystalloids (750+/-200 ml, 5.4+/-1.5 ml/kg/h). Fresh frozen plasma (median 2 units, range 1-3) was given in 20 patients (13%) if PT INR was >2. Packed red cells (median 2 units, range 1-5) were transfused in 35 patients (23%) to keep haematocrit >25%; platelets were administered before the procedure if platelet count was <50,000x10(-9) (20 patients, 13%). Urine output was kept above 4 ml/kg/h with loops diuretics (mean diuresis 700+/-200 ml, 5+/-1.5 ml/kg/h). Ten patients (6.6%) required ICU after the procedure, because of intraoperative hemodynamic instability. Three patients (2%) died in the early postoperative period because of multiple organ failure associated with the acute deterioration of an already marginal hepatic function.

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Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Freeman¹

2007

Decision Making in Anesthesiology

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The Gastroenterology Suite and TIPS

Cited by 4 publications

References 31 publications

Closed claims review of anesthesia for procedures outside the operating room

Closed claims review of anesthesia for procedures outside the operating room

Transjugular intrahepatic portosystemic shunt (TIPS): the anesthesiological point of view after 150 procedures managed under total intravenous anesthesia

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

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