| Evaluation of the pulse pressure variation index as a predictor of fluid responsiveness during orthotopic liver transplantation. | |
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MedLine Citation:
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PMID: 19454548 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The pulse pressure variation (PPV) index has been shown to be a reliable predictor of fluid responsiveness (FR) in a variety of clinical settings. However, it has not been formally evaluated in the setting of orthotopic liver transplantation (OLT). METHODS: Fifteen (n=15) patients undergoing OLT were enrolled in this study. All patients were monitored with a modified pulmonary artery catheter which measured the cardiac output on a semi-continuous basis. A fluid challenge (FC) with 350 ml of colloid was attempted during the following stages of surgery: hepatectomy (TH), anhepatic phase (TA), early post-reperfusion [(TE)--during the first 30 min], late post-reperfusion [(TL)--after hepatic artery anastomosis], and at the beginning of abdominal closure (TC). PPV and stroke volume index (SVI) were recorded at baseline and 5 min after the FC. Each individual FC which raised the SVI more than 10% from baseline was classified as responsive (R); otherwise, it was considered non-responsive (NR). RESULTS: Forty-one FCs were performed, with 14 (34%) classified as responsive and 27 (66%) as non-responsive. The baseline PPV did not differ significantly between the R and NR groups, showing considerable overlap of its values throughout the procedure [R vs NR; TH: 20% (inter-quartile range 7-32) vs 7% (5-14); TA: 10% (7-14) vs 19% (12-21), and TE+TL: 7% (5-11) vs 9% (7-16)]. CONCLUSIONS: Under the conditions of this study, the PPV index was not shown to be a reliable predictor of FR during OLT. Further studies are warranted to elucidate the role of this and other dynamic indexes in this specific setting. |
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Authors:
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G Gouvêa; R Diaz; L Auler; R Toledo; J M Martinho |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2009-05-19 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 103 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-14 Completed Date: 2009-08-13 Revised Date: 2009-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 238-43 Citation Subset: IM |
Affiliation:
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Liver Transplantation Unit, Bonsucesso General Hospital (HGB), Rio de Janeiro, Brazil. glaubergouvea@ibest.com.br |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure* Blood Pressure Determination / methods Cardiac Output Female Fluid Therapy / methods* Humans Intraoperative Care / methods Liver Transplantation* Male Middle Aged Monitoring, Intraoperative / methods* |
| Comments/Corrections | |
Comment In:
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Br J Anaesth. 2009 Dec;103(6):896-7; author reply 897-9
[PMID:
19918025
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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