Aref Ahmed, Zayan Tariq, Sharma Ajay, Halawa Ahmed
Department of Nephrology, Sur hospital, Sur 411, Sultanate of Oman.
Faculty of Health and Science, Institute of Learning and Teaching, University of Liverpool, Liverpool L69 3GB, United Kingdom.
World J Transplant. 2018 Jun 28;8(3):61-67. doi: 10.5500/wjt.v8.i3.61.
Adequate intravenous fluid therapy is essential in renal transplant recipients to ensure a good allograft perfusion. Central venous pressure (CVP) has been considered the cornerstone to guide the fluid therapy for decades; it was the only available simple tool worldwide. However, the revolutionary advances in assessing the dynamic preload variables together with the availability of new equipment to precisely measure the effect of intravenous fluids on the cardiac output had created a question mark on the future role of CVP. Despite the critical role of fluid therapy in the field of transplantation. There are only a few clinical studies that compared the CVP guided fluid therapy with the other modern techniques and their relation to the outcome in renal transplantation. Our work sheds some light on the available published data in renal transplantation, together with data from other disciplines evaluating the utility of central venous pressure measurement. Although lager well-designed studies are still required to consolidate the role of new techniques in the field of renal transplantation, we can confidently declare that the new techniques have the advantages of providing more accurate haemodynamic assessment, which results in a better patient outcome.
充足的静脉输液治疗对于肾移植受者至关重要，以确保良好的移植肾灌注。几十年来，中心静脉压（CVP）一直被视为指导液体治疗的基石；它是全球唯一可用的简单工具。然而，在评估动态前负荷变量方面的革命性进展以及精确测量静脉输液对心输出量影响的新设备的出现，对CVP的未来作用产生了一个问号。尽管液体治疗在移植领域起着关键作用，但仅有少数临床研究比较了CVP指导的液体治疗与其他现代技术及其与肾移植结局的关系。我们的工作揭示了肾移植方面已发表的可用数据，以及来自其他学科评估中心静脉压测量效用的数据。尽管仍需要更大规模、设计良好的研究来巩固新技术在肾移植领域的作用，但我们可以自信地宣称，新技术具有提供更准确血流动力学评估的优势，这会带来更好的患者结局。
