Krenn C G, Pernerstorfer T, Pokorny H, Metnitz P G, Steltzer H
Department of Anesthesiology & General Intensive Care, University of Vienna, School of Medicine, Austria.
Acta Anaesthesiol Scand. 1999 May;43(5):515-9. doi: 10.1034/j.1399-6576.1999.430505.x.
Mechanical hyperventilation is an established treatment to reduce brain edema and intracranial pressure in patients with encephalopathia caused by acute liver failure. Hyperventilation and ensuing hypocarbia may also affect central and systemic circulation and thereby influence graft performance in patients following orthotopic liver transplantation (OLT).
We measured the effects of normocapnia and hypocapnia on systemic hemodynamics, gastric tonometry, as a marker of splanchnic oxygenation, and the indocyanine green kinetic, as a global marker of graft function, in humans post OLT.
Hyperventilation was performed to a PaCO2 of 4.2 +/- 0.4 kPa (31 +/- 3.4 mm Hg) for about 1 h in 14 liver transplant recipients. Systemic hemodynamics as well as indices of splanchnic oxygenation and indocyanine green kinetics remained statistically unchanged.
We did not observe any statistically significant circulatory effects or changes in indocyanine green kinetics in liver transplant recipients in the immediate OLT postoperative period caused by short-term mechanical hyperventilation.
机械通气过度是治疗急性肝衰竭所致脑病患者脑水肿和颅内压升高的既定方法。通气过度及随之而来的低碳酸血症也可能影响中枢和全身循环，进而影响原位肝移植（OLT）患者的移植物功能。
我们在OLT术后的人体中测量了正常碳酸血症和低碳酸血症对全身血流动力学、作为内脏氧合指标的胃张力测定以及作为移植物功能整体指标的吲哚菁绿动力学的影响。
对14例肝移植受者进行了约1小时的过度通气，使动脉血二氧化碳分压（PaCO2）降至4.2±0.4 kPa（31±3.4 mmHg）。全身血流动力学以及内脏氧合指标和吲哚菁绿动力学在统计学上均无变化。
我们未观察到短期机械通气过度在OLT术后即刻对肝移植受者产生任何具有统计学意义的循环影响或吲哚菁绿动力学变化。
