Document Detail

Effects of positive end-expiratory pressure on systemic haemodynamics, with special interest to central venous and common iliac venous pressure in liver transplanted patients.
MedLine Citation:
PMID:  16723056     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Positive end-expiratory pressure may alter cardiac function and systemic haemodynamics. As transplanted livers may be sensitive to liver congestion, the aim of our study was to evaluate the effect of positive end-expiratory pressure on the cardiovascular system and in particular on central venous and iliac venous pressure in liver transplanted patients. PATIENTS AND METHODS: Seventy-two liver transplant patients were enrolled in this prospective, interventional study. On admission to our Intensive Care Unit all patients were ventilated in a biphasic positive airway pressure mode. Haemodynamic effects of three randomly set levels of end-expiratory pressures (0, 5 and 10 mbar) were studied in the immediate postoperative period in all patients. Mean arterial pressure, central venous pressure, pulmonary capillary wedge pressure, central iliac venous pressure and cardiac index were recorded and analysed at each of the three end-expiratory pressure levels. RESULTS: The values of central- and wedge-pressure significantly increased with increased end-expiratory pressure. Central venous pressure increased by 24% and wedge pressure showed a 6% increase at 10 mbar in comparison to 0 mbar. The values for cardiac index and mean arterial pressure showed no statistically significant difference at 10 mbar as compared to 0 and 5 mbar. The mean pulmonary arterial and common iliac venous pressure were unaffected by different positive end-expiratory pressure levels. CONCLUSIONS: Short-term pressure controlled ventilation with end-expiratory pressure up to 10 mbar does not significantly impair systemic haemodynamics in liver-transplanted patients. Further studies are needed to determine whether these findings could be confirmed with higher pressure levels and/or over a longer period of ventilation time.
F H Saner; G Pavlakovic; Y Gu; J Gensicke; A Paul; A Radtke; M Bockhorn; N R Fruhauf; S Nadalin; M Malagó; C E Broelsch
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-05-24
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  23     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-03     Completed Date:  2007-01-16     Revised Date:  2007-02-15    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  766-71     Citation Subset:  IM    
University Essen, Department of General Surgery and Transplantation, Germany.
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MeSH Terms
Central Venous Pressure*
Iliac Vein / pathology*
Liver / pathology*
Liver Transplantation / methods*,  pathology
Middle Aged
Positive-Pressure Respiration
Respiration, Artificial
Venous Pressure*

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