| Does PEEP impair the hepatic outflow in patients following liver transplantation? | |
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MedLine Citation:
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PMID: 16941166 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Evaluation of the impact of end-expiratory pressure (PEEP) ventilation on venous liver outflow, portal vein, and hepatic artery flows as well as systemic hemodynamics in patients following liver transplantation (LT). DESIGN: Prospective, interventional patient study. SETTING: University hospital intensive care unit. PATIENTS: 65 consecutive patients after LT. INTERVENTIONS: All patients were intubated and mechanically ventilated with biphasic positive airway pressure (BIPAP). The effects of three levels of PEEP (0, 5, and 10 mbar) applied at random order on hepatic inflow and outflow were studied in the immediate postoperative period. MEASUREMENT AND RESULTS: Central venous-, arterial pressure, and cardiac index was recorded from every patient at three different PEEP levels (0, 5, and 10 mbar). Simultaneously, flow velocities in the hepatic-, portal vein, and hepatic artery were determined by Doppler ultrasound. PEEP of 10 mbar significantly increased central venous pressure in comparison with zero PEEP. Mean arterial pressure and cardiac index was not influenced. Hepatic inflow and outflow of the transplanted livers were not impaired by any of the used PEEP levels. CONCLUSIONS: BIPAP ventilation with PEEP levels up to 10 mbar does not affect systemic hemodynamics. Furthermore, neither venous outflow nor portal venous or hepatic artery inflow of the liver are impaired at PEEP levels up to 10 mbar immediately following liver transplantation. Although these results suggest that PEEP ventilation up to 10 mbar does not affect liver hemodynamics, further studies are needed to determine whether these findings could be confirmed for a longer ventilation period with PEEP. |
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Authors:
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Fuat H Saner; Goran Pavlaković; Yanli Gu; Nils R Fruhauf; Andreas Paul; Arnold Radtke; Silvio Nadalin; Massimo Malagó; Christoph E Broelsch |
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Publication Detail:
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Type: Journal Article Date: 2006-08-29 |
Journal Detail:
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Title: Intensive care medicine Volume: 32 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-10-02 Completed Date: 2007-03-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1584-90 Citation Subset: IM |
Affiliation:
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University Clinic Essen, Department of General-, Visceral-, and Transplant Surgery, Hufelandstrasse 55, 45122 Essen, Germany. fuat.saner@uni-essen.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Blood Flow Velocity Chi-Square Distribution Female Hepatic Artery / ultrasonography Humans Intensive Care Units Intervention Studies Liver / blood supply*, ultrasonography Liver Transplantation* Male Middle Aged Portal Vein / ultrasonography Positive-Pressure Respiration* Prospective Studies Statistics, Nonparametric Ultrasonography, Doppler, Color |
| Comments/Corrections | |
Comment In:
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Liver Transpl. 2006 Dec;12(12):1903
[PMID:
17193700
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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