Ischemia-reperfusion injuryClinicalComparison of Femoral Arterial Blood Pressure With Radial Arterial Blood Pressure and Noninvasive Upper Arm Blood Pressure in the Reperfusion Period During Liver Transplantation
Section snippets
Materials and Methods
After institutional review board approval and waiver of written informed consent, we enrolled 36 adult patients who underwent living donor orthotopic liver transplantation. They were informed with clear detailed information about the anesthetic guidelines of our hospital and they gave their full agreement by preoperatively signing anesthesia permission documents. A patient diagnosed as having vascular disease was excluded.
After the induction of anesthesia, patients were mechanically ventilated
Results
The patients included 27 men and 9 women of overall mean age of 49.9 ± 8.3 years, with a mean weight of 64.5 ± 11.2 kg and a mean height of 164.2 ± 7.7 cm. Their preoperative diagnosis included 24 with liver cirrhosis, 10 with hepatocellular carcinoma, and 2 with fulminant hepatitis.
At 1 minute before reperfusion, high agreements were observed between FABP and RABP in terms of systolic, mean, and diastolic blood pressures and between FABP and NIBP in terms of systolic and mean blood pressures.
Discussion
Hemodynamic instability including PRS is frequently encountered following graft reperfusion during liver transplantation. Its manifestations are the results of acute vasodilation and ventricular dysfunction.1, 2 Therefore, to facilitate early recognition and precise evaluation of hemodynamic unstability, numerous monitoring systems are currently used in liver transplantation. The accurate measurement of blood pressure is considered a mainstay for efficient management of hemodynamic changes.
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Cited by (20)
Chapter 113 - Liver transplantation: Anesthesia, perioperative management, and postoperative care
2016, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas: Sixth EditionThe comparison of femoral and radial arterial blood pressures during pediatric liver transplantation
2013, Transplantation ProceedingsCitation Excerpt :Thus, accurate and reliable blood pressure monitoring is essential to detect and subsequently manage hemodynamic instabilities. In previous reports in adult OLT, systolic FABP was higher than systolic RABP during liver reperfusion.2,3 However, mean arterial blood pressures showed no difference throughout.2
Liver transplantation: Anesthesia, perioperative management, and postoperative care
2012, Blumgart's Surgery of the Liver, Biliary Tract and PancreasInvasive and concomitant noninvasive intraoperative blood pressure monitoring: Observed differences in measurements and associated therapeutic interventions
2011, AnesthesiologyCitation Excerpt :Although many practitioners may assume that radial artery pressure (our most common site of ABP monitoring) is an accurate measure of more central pressures, many investigators have found that radial pressure is often lower than femoral or aortic pressures.10–14 Thus, brachial pressure measured by NIBP cuff may be a better measure of central pressure when ABP indicates apparent hypotension.15 Similarly, it has been reported that pulse pressure amplification occurs in peripheral vessels, and this may cause radial pressures (particularly systolic pressures) to be higher than more central pressures16; this may help explain why NIBP is lower than ABP in hypertensive patients.
Hemodynamic monitoring in liver transplantation 'the hemodynamic system'
2024, Current Opinion in Organ TransplantationIntra-operative Management of Transplant Recipient: An Overview
2023, Peri-operative Anesthetic Management in Liver Transplantation