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Experience without using venoveno bypass in adult orthotopic liver transplantation / 대한마취과학회지
Article em En | WPRIM | ID: wpr-171970
Biblioteca responsável: WPRO
ABSTRACT
BACKGROUND: Venoveno bypass (VVB) has been used to achieve hemodynamic stability and decrease the incidence of renal dysfunction. However, VVB has many complications. The purpose of this study is to verify the safety of total clamping of the suprahepatic inferior vena cava (IVC) without VVB during orthotropic liver transplantation (OLT) in terms of anesthetic management. METHODS: Twenty-five patients without preoperative renal dysfunction who underwent primary OLT were enrolled in this study. Hemodynamic data and blood gas measurements were collected 1 hour after incision, 30 minutes after IVC total clamping and 30 minutes after reperfusion. Postoperative laboratory data, including blood urea nitrogen (BUN), creatinine (Cr) and glomerular filtration rate (GFR), were assessed at postoperative day (POD) 0-7, 30, 90, 180 and 1 year. RESULTS: Mean blood pressure was well maintained during IVC total clamping with infusion of inotropics. There was no case of severe acidosis (pH < 7.2) during the anhepatic period. The immediate postoperative Cr and GFR were not significantly different from those of the preoperative values. BUN increased from POD 1 and decreased after POD 6, while Cr increased at POD 90 only. CONCLUSIONS: In patients without preoperative renal dysfunction, when IVC was totally clamped, VVB does not need to be routinely performed to maintain hemodynamics during the anhepatic phase and renal function after OLT.
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Texto completo: 1 Índice: WPRIM Assunto principal: Acidose / Veia Cava Inferior / Pressão Sanguínea / Nitrogênio da Ureia Sanguínea / Reperfusão / Incidência / Transplante de Fígado / Constrição / Creatinina / Taxa de Filtração Glomerular Tipo de estudo: Incidence_studies / Prognostic_studies Limite: Adult / Humans Idioma: En Revista: Korean Journal of Anesthesiology Ano de publicação: 2011 Tipo de documento: Article
Texto completo: 1 Índice: WPRIM Assunto principal: Acidose / Veia Cava Inferior / Pressão Sanguínea / Nitrogênio da Ureia Sanguínea / Reperfusão / Incidência / Transplante de Fígado / Constrição / Creatinina / Taxa de Filtração Glomerular Tipo de estudo: Incidence_studies / Prognostic_studies Limite: Adult / Humans Idioma: En Revista: Korean Journal of Anesthesiology Ano de publicação: 2011 Tipo de documento: Article