TY - JOUR
T1 - Systemic-to-pulmonary artery pressure ratio as a predictor of patient outcome following liver transplantation
AU - Rebel, Annette
AU - Nguyen, Dung
AU - Bauer, Brooke
AU - Sloan, Paul A.
AU - DiLorenzo, Amy
AU - Hassan, Zaki Udin
N1 - Publisher Copyright:
© 2016 Baishideng Publishing Group Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - AIM To assess the value of the mean systemic-to-pulmonary artery pressure (MAP/mPAP) ratio for predicting outcomes following orthotopic liver transplant (OLT). METHODS A retrospective data analysis was performed and data (mean arterial blood pressure, mean pulmonary artery pressure and Cardiac Index) were collected at several points during OLT. Outcomes evaluated were duration of postoperative endotracheal intubation [ET; minutes after intensive care unit (ICU) arrival], length of ICU stay, total hospitalization and frequency of immediate postoperative complications. A total of 91 patients were included in the data analysis. Based on the intraoperative course of the MAP/mPAP ratio, 2 hemodynamic responses were identified: Group 1 (MAP/mPAP ratio increase during anhepatic period with postreperfusion recovery, n = 66); and Group 2 (MAP/ mPAP ratio with no change during anhepatic period or decreased without recovery, n = 25). RESULTS The main finding was that the lack of increased MAP/ mPAP ratio in the anhepatic period was associated with: (1) longer intubation times; and (2) prolonged ICU stays and total hospitalization time, when compared to patients with an increase in MAP/mPAP ratio during the anhepatic period. CONCLUSION The data from this retrospective study should raise awareness to the mean systemic to pulmonary artery pressure ratio as a potential indicator for poor outcome after OLT. Further prospective studies are needed for validation.
AB - AIM To assess the value of the mean systemic-to-pulmonary artery pressure (MAP/mPAP) ratio for predicting outcomes following orthotopic liver transplant (OLT). METHODS A retrospective data analysis was performed and data (mean arterial blood pressure, mean pulmonary artery pressure and Cardiac Index) were collected at several points during OLT. Outcomes evaluated were duration of postoperative endotracheal intubation [ET; minutes after intensive care unit (ICU) arrival], length of ICU stay, total hospitalization and frequency of immediate postoperative complications. A total of 91 patients were included in the data analysis. Based on the intraoperative course of the MAP/mPAP ratio, 2 hemodynamic responses were identified: Group 1 (MAP/mPAP ratio increase during anhepatic period with postreperfusion recovery, n = 66); and Group 2 (MAP/ mPAP ratio with no change during anhepatic period or decreased without recovery, n = 25). RESULTS The main finding was that the lack of increased MAP/ mPAP ratio in the anhepatic period was associated with: (1) longer intubation times; and (2) prolonged ICU stays and total hospitalization time, when compared to patients with an increase in MAP/mPAP ratio during the anhepatic period. CONCLUSION The data from this retrospective study should raise awareness to the mean systemic to pulmonary artery pressure ratio as a potential indicator for poor outcome after OLT. Further prospective studies are needed for validation.
KW - Anesthesiology
KW - Liver transplantation
KW - Morbidity
KW - Outcome
KW - Right heart function
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U2 - 10.4254/wjh.v8.i32.1384
DO - 10.4254/wjh.v8.i32.1384
M3 - Article
AN - SCOPUS:85002670900
VL - 8
SP - 1384
EP - 1391
JO - World Journal of Hepatology
JF - World Journal of Hepatology
IS - 32
ER -