Transesophageal echocardiography and orthotopic liver transplantation: General concepts

Wolf, A. De

doi:10.1002/lt.500050408

Cited by 34 publications

(17 citation statements)

References 22 publications

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“…During anesthesia for LTx, 3‐dimensional echocardiography can be used, although it is not considered to be a routine monitoring technique 25–27. In particular, the short‐axis view of the left ventricle (transgastric view) provides excellent visualization of the left ventricular dimension and function, and LVEDAI correlates well with changes in SVI during volume therapy 28, 29.…”

Section: Discussionmentioning

confidence: 99%

Continuous right ventricular end diastolic volume and right ventricular ejection fraction during liver transplantation: A multicenter study

et al. 2008

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Cardiac preload is traditionally considered to be represented by its filling pressures, but more recently, estimations of end diastolic volume of the left or right ventricle have been shown to better reflect preload. One method of determining volumes is the evaluation of the continuous right ventricular end diastolic volume index (cRVEDVI) on the basis of the cardiac output thermodilution technique. Because preload and myocardial contractility are the main factors determining cardiac output during liver transplantation (LTx), accurate determination of preload is important. Thus, monitoring of cRVEDVI and cRVEF should help with fluid management and with the assessment of the need for inotropic and vasoactive agents. In this multicenter study, we looked for possible relationships between the stroke volume index (SVI) and cRVEDVI, cRVEF, and filling pressures at 4 predefined steps in 244 patients undergoing LTx. Univariate and multivariate autoregression models (across phases of the surgical procedure) were fitted to assess the possible association between SVI and cRVEDVI, pulmonary artery occlusion pressure (PAOP), and central venous pressure (CVP) after adjustment for cRVEF (categorized as Յ30, 31-40, and Ͼ40%). SVI was strongly associated with both cRVEDVI and cRVEF. The model showing the best fit to the data was that including cRVEDVI. Even after adjustment for cRVEF, there was a statistically significant (P Ͻ 0.05) relationship between SVI and cRVEDVI with a regression coefficient (slope of the regression line) of 0.25; this meant that an increase in cRVEDVI of 1 mL m Ϫ2 resulted in an increase in SVI of 0.25 mL m Ϫ2. The correlations between SVI and CVP and PAOP were less strong. We conclude that cRVEDVI reflected preload better than CVP and PAOP.

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Section: Discussionmentioning

confidence: 99%

Continuous right ventricular end diastolic volume and right ventricular ejection fraction during liver transplantation: A multicenter study

et al. 2008

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“…Maintaining the high cardiac output of liver transplant recipients is essential to ensure adequate perfusion of tissues. However, maintaining this high cardiac output can only be accomplished by maintaining preload, which may be difficult given that the operation itself is associated with major changes in volume and afterload 51. Intraoperatively, cardiac output may be decreased by reduced preload or impaired myocardial contractility.…”

Section: Intraoperative Considerations and Complicationsmentioning

confidence: 99%

Cardiac morbidity and mortality related to orthotopic liver transplantation

et al. 2004

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“…Studies of TEE in OLT using initial and/or intraoperative reassessment have shown improved monitoring of volume status and myocardial function with significant improvement in therapy, leading to the conclusion that TEE use is safe, even when esophageal varices are present [5,[10][11][12]. However, use of TEE requires experience.…”

Section: Discussionmentioning

confidence: 95%

Early echocardiographic detection of a massive intracardiac thrombus in a patient scheduled for orthotopic liver transplantation

Mutlak

Wilke

Moench

et al. 2012

Journal of Clinical Anesthesia

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Transesophageal echocardiography and orthotopic liver transplantation: General concepts

Cited by 34 publications

References 22 publications

Continuous right ventricular end diastolic volume and right ventricular ejection fraction during liver transplantation: A multicenter study

Continuous right ventricular end diastolic volume and right ventricular ejection fraction during liver transplantation: A multicenter study

Cardiac morbidity and mortality related to orthotopic liver transplantation

Early echocardiographic detection of a massive intracardiac thrombus in a patient scheduled for orthotopic liver transplantation

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