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The evolution of diastolic function during liver transplantation.
- Source :
-
Anaesthesia, critical care & pain medicine [Anaesth Crit Care Pain Med] 2018 Apr; Vol. 37 (2), pp. 155-160. Date of Electronic Publication: 2016 Dec 24. - Publication Year :
- 2018
-
Abstract
- Introduction: The peroperative management of liver transplantation is still associated with many cardiocirculatory complications in which diastolic dysfunction may play a contributive role. Transoesophageal echocardiography is a monitoring device commonly used in liver transplantation allowing diastolic function assessment.<br />Methods: We prospectively analysed the peroperative transoesophageal echocardiography recordings of 40 patients undergoing liver transplantation in order to describe changes in diastolic function at different steps of the surgery. The diastolic function marker we used was the lateral mitral annulus motion (E' wave velocity) obtained by tissue-Doppler imaging. In addition, we also studied the left ventricular filling pressure indices and systolic function.<br />Results: As a whole, there was no global change in E' wave velocity throughout the surgery. However, 11 patients (27.5%) presented a decrease in E' wave velocity up to 15% that identified an occurrence of diastolic function alteration. In this group, other peroperative data were not different from other patients (amount of bleeding, fluid administration or vasopressive support). Conversely, this group experienced lower preoperative E' wave velocity values (9cm·s <superscript>-1</superscript> versus 12cm·s <superscript>-1</superscript> , P=0.05) and an increased incidence of postoperative cardiorespiratory complications (OR=6 [1-56], P=0.02). Considering all patients, 18 patients had an E' wave velocity under 10cm·s <superscript>-1</superscript> at unclamping, characterizing a diastolic dysfunction according to the usual criteria. This dysfunction was not associated with cardiorespiratory complications.<br />Conclusion: This work investigated peroperative systematic echocardiographic evaluation of diastolic function during liver transplantation. Diastolic dysfunction occurs frequently during liver transplantation and could lead to postoperative cardiorespiratory complications.<br /> (Copyright © 2017 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Blood Pressure
Echocardiography, Doppler
Echocardiography, Transesophageal
Female
Heart Diseases epidemiology
Heart Diseases etiology
Humans
Incidence
Male
Middle Aged
Monitoring, Intraoperative
Postoperative Complications epidemiology
Reperfusion Injury physiopathology
Reperfusion Injury prevention & control
Respiration Disorders epidemiology
Respiration Disorders etiology
Ventricular Function, Left
Young Adult
Diastole
Liver Transplantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 2352-5568
- Volume :
- 37
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Anaesthesia, critical care & pain medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28024925
- Full Text :
- https://doi.org/10.1016/j.accpm.2016.09.009