Document Detail


Does long-term ventilation with PEEP > or = 10mbar influence graft-function in patients following liver transplantation?
MedLine Citation:
PMID:  21033239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Long-term positive end-expiratory pressure (PEEP) ventilation, particular with PEEP up to 15 mbar may impair graft-function in liver transplant (LT) patients. The aim of our study was to evaluate the impact of long-term high PEEP (at least 48 hours) on liver graft function. We retrospectively reviewed the records of 50 patients, who required artificial ventilation for at least 1 week with a PEEP level > or = 10mbar due to pulmonary complication caused mainly by sepsis (n = 19), pneumonia (n = 7) and lung edema associated with reperfusion syndrome or primary non-function of the graft (n = 13). Patients who required a PEEP > or = 10mbar within the first two days after transplantation (group A, n = 23) showed significant decrease of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin on day 3 and day 7 after initiation of high PEEP, whereas prothrombin time (PT) significantly increased on day 7. Group B (patients ventilated with PEEP > or = 10mbar after more than 2 days after transplantation, n = 27) showed a significant decrease of bilirubine and a significantly increase of PT on day 7.
CONCLUSION: Long-term ventilation with PEEP levels of at least 10mbar does not harm graft function in patients following LT.
Authors:
Peri Kocabayoglu; Jürgen Walter Treckmann; Susanne Beckebaum; Georgios C Sotiropoulos; Arnold Radtke; Andreas Paul; Fuat Hakan Saner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  57     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-10-29     Completed Date:  2011-01-06     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  839-44     Citation Subset:  IM    
Affiliation:
Department of General, Visceral and Transplant Surgery, University Clinic Essen, Hufelandstr. 55, 45122 Essen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Alanine Transaminase / blood
Aspartate Aminotransferases / blood
Bilirubin / blood
Female
Humans
Liver Diseases / physiopathology,  surgery
Liver Transplantation / physiology*
Male
Middle Aged
Positive-Pressure Respiration / methods*
Postoperative Period
Retrospective Studies
Chemical
Reg. No./Substance:
635-65-4/Bilirubin; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

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