The relationship between the decrease of end expiratory carbon dioxide during liver transplantation and the occurrence of acute kidney injury after surgery
10.3760/cma.j.cn431274-20231226-00727
- VernacularTitle:肝移植术中呼气末二氧化碳下降与术后发生急性肾损伤的关系
- Author:
Yongyi CHEN
1
;
Yaqi XU
;
Shiwei YANG
;
Dongdong HAN
;
Jun DUAN
Author Information
1. 中日友好医院（中日友好临床医学研究所）/北京协和医学院/中国医学科学院，北京 100730
- Keywords:
Liver transplantation;
End-tidal carbon dioxide;
Acute kidney injury
- From:
Journal of Chinese Physician
2024;26(4):538-542
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate whether end-tidal carbon dioxide (etCO 2) is associated with acute kidney injury (AKI) after liver transplantation. Methods:Clinical data of 83 patients undergoing classic allogeneic liver transplantation were retrospectively collected. Patients were divided into AKI group and non AKI group based on changes in serum creatinine levels within 48 hours after surgery, and differences in baseline data, intraoperative etCO 2 decrease rate [ΔetCO 2(%)], and postoperative creatinine values were analyzed between the groups. Results:The incidence of AKI within 48 hours after liver transplantation in 83 patients was 56.6%(47/83). The proportion of male patients in the AKI group was higher ( P=0.003), and the ΔetCO 2(%) in the anhepatic phase of AKI group patients was higher than that of non AKI patients [(0.26±0.08)% vs (0.22±0.07)%, P=0.024]. There was no statistically significant difference in ΔetCO 2(%) between the two groups during pre liver, inferior vena cava (IVC) occlusion, and new liver phase (all P>0.05). On the 7th day after surgery, the creatinine value in the AKI group was significantly higher than that in the non AKI group [68.7(55.4, 92.6)]μmol/L vs 52.7(44.1, 69.3)μmol/L, P<0.001], at a 3-month follow-up, creatinine levels in 43 patients (91.5%) in the AKI group returned to normal. Conclusions:The decrease in ΔetCO 2(%) during the anhepatic phase of liver transplantation reflects to some extent the severe fluctuations in circulation during the operation, which may be related to the occurrence of AKI within 48 hours after surgery.
