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Preload and haemodynamic assessment during liver transplantation: a comparison between the pulmonary artery catheter and transpulmonary indicator dilution techniques.

Della Rocca G
•
Costa MG
•
Coccia C
altro
Pietropaoli P.
2002
  • journal article

Periodico
EUROPEAN JOURNAL OF ANAESTHESIOLOGY
Abstract
Background and objective: Liver transplantation is characterized by several changes in intravascular blood vol- ume due to vasodilatation based on neurohumoral mediators, intraoperative bleeding and anaesthesia technique effects. Today, with the transpulmonary indicator dilution technique, cardiac index (CIart) can be evaluated and preload assessed in terms of the intrathoracic blood volume index (ITBVI). The aim was to analyse in patients undergoing liver transplantation two preload variables, pulmonary artery occlusion pressure (PAOP) and ITBVI with respect to cardiac index (CIpa) and stroke volume index (SVIpa), the correlation between ITBVI and PAOP, and secondary the relationship between the changes (D) of ITBVI and PAOP and the changes of CIpa and SVIpa, and the relationships between DITBVI and DPAOP. The reproducibility and precision of all CIart and CIpa measurements were also evaluated. Methods: A prospective study was performed in 60 patients monitored with a pulmonary artery catheter and with the PiCCO® system. The variables were evaluated with a linear regression model. Results: Linear regression analysis between ITBVI-CIpa and ITBVI-SVIpa were r2 5 0.47 (P , 0.0001) and r2 5 0.55 (P , 0.0001) respectively, while PAOP poorly correlated to CIpa (r2 5 0.02), SVIpa (r2 5 0.015) and ITBVI (r2 5 0.002). Only changes in ITBVI were correlated with changes in CIpa (D1, r2 5 0.37; D2, r2 5 0.32), and SVIpa (D1, r2 5 0.60; D2, r2 5 0.47). The mean bias between CIart and CIpa was 0.13 L min21 m22 (2 SD 5 1.04 L min21 m22) (r2 5 0.86, P , 0.0001). Conclusions: In comparison with PAOP, ITBVI seems a more reliable indicator of cardiac preload in patients undergoing liver transplantation.
DOI
10.1017/S0265021502001394
WOS
WOS:000180098200003
SCOPUS
2-s2.0-0036900820
Archivio
http://hdl.handle.net/11390/879968
Diritti
closed access
Soggetti
  • cardiac output

  • diagnostic techniques...

  • cardiovascular

  • thermodilution

  • dilution techniques

  • liver transplantation...

  • blood volume determin...

Web of Science© citazioni
56
Data di acquisizione
Jun 1, 2022
Scopus© citazioni
74
Data di acquisizione
Jun 7, 2022
Vedi dettagli
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