Document Detail


Is positive end-expiratory pressure suitable for liver recipients with a rescue organ offer?
MedLine Citation:
PMID:  19942400     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Rescue organ offers may help to overcome the organ shortage. However, because of initial poor liver function, the recipient may develop a severe lung injury with the requirement for higher positive end-expiratory pressure (PEEP) levels to achieve adequate oxygenation. Positive end-expiratory pressure has been associated with perfusion impairment in the hepatosplanchnic area. We assessed the effects of increased PEEP levels on systemic hemodynamic and liver perfusion in liver transplantation (LT) patients with a rescue organ.
METHODS: Twenty-four LT recipients of a rescue organ offer were enrolled. All patients were postoperatively mechanically ventilated with biphasic positive airway pressure, and 3 different PEEP levels (0, 5, 10 mbar) were randomly set within 4 hours after admission at the intensive care unit. Systemic hemodynamic parameters were recorded using a pulmonary artery catheter; and flow velocities of the hepatic artery, portal vein, and right hepatic vein were measured using Doppler.
RESULTS: Positive end-expiratory pressure of 10 mbar did not impair the systemic hemodynamic. Flow velocities in the right hepatic vein, the portal vein, and the hepatic artery were not influenced by PEEP.
CONCLUSION: Our study demonstrates that PEEP up to 10 mbar did not impair the liver outflow in recipients with a rescue organ offer.
Authors:
Fuat H Saner; Steven W M Olde Damink; Goran Pavlaković; Georgios C Sotiropoulos; Arnold Radtke; Juergen Treckmann; Susanne Beckebaum; Vito Cicinnati; Andreas Paul
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-26
Journal Detail:
Title:  Journal of critical care     Volume:  25     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-14     Completed Date:  2010-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  477-82     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of General-, Visceral- and Transplant Surgery, University Hospital Essen, 45122 Essen, Germany. fuat.saner@uni-due.de
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity
Female
Humans
Liver / blood supply*
Liver Circulation / physiology
Liver Transplantation / physiology*
Lung Injury / etiology,  physiopathology
Male
Middle Aged
Positive-Pressure Respiration* / adverse effects
Tissue and Organ Procurement*
Treatment Outcome

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


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