Document Detail

Intraoperative hemodynamic monitoring during organ transplantation: what is new?
MedLine Citation:
PMID:  19448537     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: To highlight the recent developments in hemodynamic monitoring during liver and lung transplantation. RECENT FINDINGS: Even though a consensus on intraoperative hemodynamic monitoring is still lacking, the most frequently monitoring tool used is the pulmonary artery catheter (PAC). The filling pressures are widely accepted as not being able to accurately define cardiac preload. On the contrary, the use of transesophageal echocardiography (TEE), although it is operator dependent and requires a prolonged training, is increasing during the intraoperative period to directly evaluate the cardiovascular function. New frontiers have been opened by the transpulmonary thermodilution: intrathoracic blood volume has been shown to have a better correlation with preload than the filling pressures. The advanced modified PAC permits evaluation of the right heart function and preload. Recently, right ventricular end diastolic volume has been shown to correlate better with preload than the filling pressures and also the left ventricular end diastolic area. SUMMARY: The PAC still represents the most used intraoperative hemodynamic monitoring technique. TEE is increasing in popularity. Recent studies demonstrate that volumetric monitoring conducted with transpulmonary thermodilution and advanced volumetric PAC give good definition of preload and should be implemented in clinical practice.
Giorgio Della Rocca; Anita Brondani; Maria Gabriella Costa
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in organ transplantation     Volume:  14     ISSN:  1531-7013     ISO Abbreviation:  Curr Opin Organ Transplant     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9717388     Medline TA:  Curr Opin Organ Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  291-6     Citation Subset:  IM    
Clinic of Anesthesia and Intensive Care Medicine, Department of Surgical Science, Medical School, University of Udine, P.le S. M. Misericordia, Udine 15-33100, Italy.
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MeSH Terms
Blood Pressure
Blood Volume
Catheterization, Swan-Ganz / trends
Echocardiography, Transesophageal / trends
Liver Transplantation* / adverse effects
Lung Transplantation* / adverse effects
Monitoring, Intraoperative / trends*
Predictive Value of Tests
Thermodilution / trends
Ventricular Function, Left
Ventricular Function, Right

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

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