[Influence of preoperative propranolol on cardiac index during the anhepatic phase of liver transplantation].

Autor:	Seiberlich E; Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil. Electronic address: seiberlich@gmail.com., Sanches MD; Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil., Morais BS; Hospital Life Center, Belo Horizonte, MG, Brasil., Maciel JF; Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.
Jazyk:	portugalština
Zdroj:	Revista brasileira de anestesiologia [Rev Bras Anestesiol] 2015 May-Jun; Vol. 65 (3), pp. 170-6. Date of Electronic Publication: 2014 Nov 01.
DOI:	10.1016/j.bjan.2014.02.016
Abstrakt:	Introduction: Liver transplantation (LT) is the best therapeutic option for end-stage liver disease (ESLD). Non-selective beta-blocker medications such as propranolol act directly on the cardiovascular system (CVS) and are often used in the prevention of gastrointestinal bleeding resulting from HP. The effects of propranolol on CVS of cirrhotic patients during LT are not known. Objective: Evaluate the influence of propranolol used preoperatively on cardiac index (CI) during the anhepatic phase of LT. Method: 101 adult patients (73 male [72.2%]) who underwent cadaveric donor orthotopic liver transplantation by piggyback technique with preservation of the retrohepatic inferior vena cava performed at Hospital das Clinicas, Federal University of Minas Gerais were evaluated. There was no difference in severity between groups by the MELD system, p=0.70. The preoperative use of propranolol and the CI outcome were compared during the anhepatic phase of LT in 5 groups (I: increased CI, II: CI reduction lower than 16%, III: CI reduction equal to or greater than 16% and less than 31%, IV: CI reduction equal to or greater than 31% and less than 46%, V: CI reduction equal to or greater than 46%). Results: Patients in group I (46.4%) who received propranolol preoperatively were statistically similar to groups II (60%), III (72.7%), IV (50%) and V (30.8%), p=0.57. Conclusion: The use of propranolol before transplantation as prophylaxis for gastrointestinal bleeding may be considered safe, as it was not associated with worsening of CI in anhepatic phase of LT. (Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)
Databáze:	MEDLINE
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