Zhao Lei, Wang Tian-long
Department of Anaesthesia, Peking University People's Hospital, Beijing 100044, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2009 Apr 18;41(2):188-91.
To explore the feasibility of guiding the volume management during orthotopic liver transplantation by right ventricular end-diastolic volume index(RVEDVI).
Thirty-two patients who accepted OLT were studied during operation. A modified pulmonary artery catheter equipped with a fast response thermistor (774HF75)was used to determine RVEDVI, EF, CCI, CVP, MPAP, PAOP and SVI. The above-mentioned hemodynamic measures were taken in 9 phases: T0, before induction of anesthesia; T1, before operation; T2, pre-anhepatic phase; T3, 30 minutes after PV occlusion; T4, 10 minutes after graft reperfusion; T5, 30 minutes after graft reperfusion; T6, 60 minutes after graft reperfusion; T7, 120 minutes after graft reperfusion; and T8, at the end of surgery. The linear regression analyses of SVI and CVP, SVI and PAOP, SVI and RVEDVI in each phase were calculated, and the best measure of representing the volume of the OLT patient was selected.
The variation of the RVEF value was (42.04+/-9.40)%. Linear regression analyses showed a significant correlation between RVEDVI and stroke volume index (SVI) in each phase(P<0.05). No relationships were found between PAOP and SVI, CVP and SVI.
RVEDVI may be the best hemodynamic measure of evaluating the volume of the OLT patients.
