Physiological Changes during Liver Transplantation
| Autor: | Kevin A. Rickard, M. Kalpokas, A. G. R. Sheil, M. Bookallil |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
Adult
Adolescent medicine.medical_treatment Cardiac index Hemodynamics Liver transplantation Critical Care and Intensive Care Medicine Intraoperative Period Fibrinolysis Heart rate medicine Humans Anesthesia Child Coagulation Disorder Monitoring Physiologic Retrospective Studies business.industry Infant Hydrogen-Ion Concentration Middle Aged Liver Transplantation Transplantation Anesthesiology and Pain Medicine Blood pressure Child Preschool Reperfusion Potassium Blood Coagulation Tests business |
| Zdroj: | Anaesthesia and Intensive Care. 17:24-30 |
| ISSN: | 1448-0271 0310-057X |
| DOI: | 10.1177/0310057x8901700106 |
| Popis: | Thirteen patients who received liver transplants at the National Liver Transplant Unit between January 1986 and March 1987 were studied with extensive monitoring and frequent intraoperative biochemical and haematological profiles. Anaesthetic technique was standardised for all patients. Retrospective analysis of this data confirms that patient homeostasis is most disturbed at the time of revascularisation of the donor liver. In this series, revascularisation was associated with marked changes in all measured haemodynamic parameters (arterial blood pressure, cardiac index, heart rate, and filling pressures). There was also a significant fall in pH with revascularisation, followed by a gradual rise during the final phases of the operation. Potassium levels often rose sharply with revascularisation but then decreased during the rest of the operative period. Ionised calcium levels did not change significantly at any stage; however, all patients were given calcium intraoperatively. Coagulation profiles were often abnormal preoperatively. The transplant procedure was associated with further abnormalities in both coagulation and fibrinolysis. Patient temperatures were maintained at normal levels throughout the procedure. |
| Databáze: | OpenAIRE |
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