未知的边缘：肝移植术后重症监护

Saner Fuat H, Hoyer Dieter P, Hartmann Matthias, Nowak Knut M, Bezinover Dmitri

Department of General-, Visceral- and Transplant Surgery, Medical Center University Duisburg-Essen, 45147 Essen, Germany.

Department of Anaesthesia and Critical Care, Medical Center University Duisburg-Essen, 45147 Essen, Germany.

J Clin Med. 2022 Jul 12;11(14):4036. doi: 10.3390/jcm11144036.

Perioperative care of patients undergoing liver transplantation (LT) is very complex. Metabolic derangements, hypothermia, coagulopathy and thromboses, severe infections, and graft dysfunction can affect outcomes. In this manuscript, we discuss several perioperative problems that can be encountered in LT recipients. The authors present the most up-to-date information regarding predicting and treating hemodynamic instability, coagulation monitoring and management, postoperative ventilation strategies and early extubation, management of infections, and ESLD-related pulmonary complications. In addition, early post-transplant allograft dysfunction will be discussed.

肝移植（LT）患者的围手术期护理非常复杂。代谢紊乱、体温过低、凝血功能障碍和血栓形成、严重感染以及移植物功能障碍都会影响治疗结果。在本手稿中，我们讨论了LT受者可能遇到的几个围手术期问题。作者介绍了有关预测和治疗血流动力学不稳定、凝血监测与管理、术后通气策略和早期拔管、感染管理以及与终末期肝病（ESLD）相关的肺部并发症的最新信息。此外，还将讨论移植后早期移植物功能障碍。