Study of hemodynamic and cardiac function changes in pediatric liver transplantation from living related donors
10.3760/cma.j.issn.0254-1785.2017.11.005
- VernacularTitle:婴幼儿亲属活体肝移植受者术中血流动力学及心功能的变化
- Author:
Qingping WANG
1
;
Xiaojing DOU
;
Wenli YU
;
Hongyin DU
;
Wenguang PANG
;
Yongwang WANG
;
Yonghao YU
Author Information
1. 300192,天津市第一中心医院麻醉科 天津医科大学一中心临床学院
- Keywords:
Pediatric;
Liver transplantation;
Hemodynamic;
Cardiac output
- From:
Chinese Journal of Organ Transplantation
2017;38(11):660-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes of hemodynamics and cardiac function in pediatric living donor liver transplantation (LDLT).Methods 50 cases of pediatric living donor liver transplantation in our hospital from January 2016 to January 2017 were collected.The hemodynamics was monitored by Mostcare with the radial artery.Acquisition of heart rate (HR),mean arterial pressure (MAP),peripheral vascular resistance index (SVR/SVRI),stroke volume / stroke index (SV/SVI),cardiac output (CO/CI),cardiac index / stroke volume variability (SVV),dp/dtmax (cardiac contractility),cardiac cycle efficiency (CCE) at the moment of the start of operation(T0),before occlusion of the inferior vena cava (T1),immediately after occlusion of the inferior vena cava (T2),anhepatic phase 30 min (T3),immediately after reperfusion(T4),neohepatic phase 5 min (T5),30 min (T6) and 60 min (T7).Results There were no significantly hemodynamic fluctuations before occlusion of the portal vein.At T3,the increased of MAP,CI,SVRI (T3 vs T0,P＜0.05),while CCE decreased significantly (T3 vs T0,P＜0.05);MAP,SVRI,lower HR,CI and dp/dtmax have different degrees of liver T4,but the change was not significant.SVV fluctuated in the anhepatic phase at 11％ ～ 15％,maintained in the new liver stage at 12％ ～ 15％,but fluctuated slightly.Conclusion Mostcare can be used to monitor the hemodynamic and cardiac function changes in pediatric living donor liver transplantation,but the reasons for the change of the monitoring indicators and the significance of guiding the perioperative treatment need to be further studied.
