Document Detail


Positive end-expiratory pressure induces liver congestion in living donor liver transplant patients: myth or fact.
MedLine Citation:
PMID:  18580483     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Living-donated liver transplant (LDLT) patients may develop lung edema during reperfusion, requiring higher positive end-expiratory pressure (PEEP) levels, which may impair liver outflow. The aim of the study was to assess the effect of increased PEEP levels on venous liver outflow and systemic hemodynamics in patients after LDLT. Thirty-nine LDLT recipients were enrolled in this study. All patients were postoperatively pressure-controlled ventilated and three different PEEP levels (0, 5 and 10 mbar) were randomly set. Systemic hemodynamic parameters and flow velocities of the hepatic artery, portal vein, and right hepatic vein were recorded at each PEEP level. PEEP of 10 mbar increased significantly central venous and pulmonary capillary pressure. Flow velocities in the right hepatic vein, the portal vein, the hepatic artery, mean arterial pressure, pulmonary arterial pressure, and cardiac index were not influenced by PEEP. Our study demonstrated that PEEP up to 10 mbar did not impair liver outflow in LDLT recipients.
Authors:
Fuat H Saner; Steven W M Olde Damink; Goran Pavlaković; Maartje A J van den Broek; Georgios C Sotiropoulos; Arnold Radtke; Silvio Nadalin; Massimo Malagó; Andreas Paul
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Transplantation     Volume:  85     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-26     Completed Date:  2008-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1863-6     Citation Subset:  IM    
Affiliation:
Department of General-, Visceral- and Transplant Surgery, University Hospital Essen, Essen, Germany. fuat.saner@uni-due.de
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity / physiology
Blood Pressure / physiology
Female
Hepatic Artery / physiology
Hepatic Veins / physiology
Humans
Liver / blood supply*
Liver Transplantation / physiology*
Living Donors*
Male
Middle Aged
Portal Vein / physiology
Positive-Pressure Respiration / adverse effects*
Regional Blood Flow / physiology

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


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