Document Detail


Continuous right ventricular end diastolic volume and right ventricular ejection fraction during liver transplantation: a multicenter study.
MedLine Citation:
PMID:  18306366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 < or =30, 31-40, and >40%). 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 < 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(-2) resulted in an increase in SVI of 0.25 mL m(-2). The correlations between SVI and CVP and PAOP were less strong. We conclude that cRVEDVI reflected preload better than CVP and PAOP.
Authors:
Giorgio Della Rocca; Maria Gabriella Costa; Paolo Feltracco; Gianni Biancofiore; Bruno Begliomini; Stefania Taddei; Cecilia Coccia; Livia Pompei; Pierangelo Di Marco; Paolo Pietropaoli
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  14     ISSN:  1527-6473     ISO Abbreviation:  Liver Transpl.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-04     Completed Date:  2008-06-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-32     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Intensive Care Medicine, University of Udine, Azienda Ospedaliera Universitaria, Udine, Italy. giorgio.dellarocca@uniud.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Algorithms
Blood Volume / physiology
Cardiac Output / physiology
Female
Humans
Liver Transplantation / physiology*
Male
Middle Aged
Monitoring, Intraoperative / methods
Multivariate Analysis
Stroke Volume / physiology*
Thermodilution / methods
Ventricular Function, Right / physiology*
Comments/Corrections
Comment In:
Liver Transpl. 2008 Mar;14(3):268-9   [PMID:  18306387 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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