Document Detail


Modifications of cerebral vascular resistance and autoregulation after graft reperfusion during human orthotopic liver transplantation.
MedLine Citation:
PMID:  15251361     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have studied cerebral blood flow velocity (CBFV) and cerebral autoregulation (CA) in 23 orthotopic liver transplantation (OLT) patients using transcranial doppler. CBFV was continuously recorded using a fixed (helmet) 2-Mz probe through the trans-temporal window. CA changes were studied using a linear regression analysis of percentile changes in CBFV and mean arterial blood pressure (MABP) after phenylephrine infusion compared with baseline. Pearson's "r" coefficient was considered an index of CA. In case of autoregulation is lost "r" tends to 1, thus representing complete dependence of CBFV on MABP. We regarded the slope coefficient parameter "S" as an index of cerebral vascular resistance (CVR), namely, the ratio of the corresponding variations of CBFV to MABP. Wilcoxon test showed a significant increase in both "r" and "S" between the anhepatic versus postreperfusion phases (within the first hour) and versus recovery in the neohepatic phase (end of surgery). A decreased CVR was observed within the first hour after graft reperfusion producing a loss of CA. These phenomena lead to an increase of CBFV and exposed the brain to hyperperfusion.
Authors:
G Ardizzone; A Arrigo; F Panaro; M Centanaro; M Demartini; A Pellizzari; A Cifelli; T M Jarzembowski; T M Jarzembowsky; U Valente; C Siani
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  36     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-07-14     Completed Date:  2005-03-07     Revised Date:  2005-03-24    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1473-8     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Elsevier Inc.
Affiliation:
Department of Anesthesiology-Critical Care, Osp. S. Martino e Cliniche Universitarie Convenzionate, Genova, Italy.
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MeSH Terms
Descriptor/Qualifier:
Cerebrovascular Circulation / physiology*
Female
Homeostasis
Humans
Liver Transplantation / methods,  physiology*
Male
Middle Aged
Monitoring, Intraoperative
Reperfusion*
Vascular Resistance / physiology*
Comments/Corrections
Erratum In:
Transplant Proc. 2004 Jul-Aug;36(6):1853
Note: Jarzembowsky TM [corrected to Jarzembowski, TM]

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


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