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Impact of cytokine release on ventricular function after hepatic reperfusion: a prospective observational echocardiographic study with tissue Doppler imaging
- Source :
- BMC Anesthesiology
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- Background Postreperfusion syndrome and haemodynamic instability are predictors for poor outcome after liver transplantation. Cytokine release has been claimed to be responsible for postreperfusion syndrome. However, the underlying pathophysiologic mechanism is not clarified. The aim of this prospective observational study was to correlate cardiac performance (measured by transoesophageal echocardiography (TEE), Doppler and Tissue Doppler Imaging (TDI)) to plasmatic cytokines: IL-6, IL-8, CXCL1, TGF-β and CD40L at 5 different time points during liver transplantation. Methods Seventeen consecutive patients scheduled for orthotopic liver transplantation, age 18 to 75 years without contraindication for transoesophageal echocardiography were included. Patients were monitored with TEE and TDI. Systolic and diastolic cardiac function, MAP, MPAP, CVP, PCWP, CO and blood samples for cytokine assays were recorded or collected after induction, 15 min after vena cava inferior clamping, 2 to 5 min after reperfusion, 60 min after reperfusion and at the end of surgery. Results Mean arterial pressure and catecholamine requirements remained unchanged, MPAP, CVP and CO increased, SVR decreased after unclamping. Postreperfusion syndrome did not develop. The haemodynamic parameters and the variations of TEE parameters were consistent with the volume load changes during clamping and declamping and did not reveal systolic or diastolic cardiac dysfunction. All cytokines, except TGF-β, increased. Conclusion These findings suggest, that significant cytokine release during liver transplantation is not necessarily coincident with haemodynamic instability and impaired cardiac function. Trial registration ClinicalTrials.gov: NCT00547924
- Subjects :
- Adult
Male
Cardiac function curve
medicine.medical_specialty
Mean arterial pressure
Adolescent
medicine.medical_treatment
Diastole
Hemodynamics
610 Medicine & health
Liver transplantation
Doppler imaging
Young Adult
Internal medicine
medicine
Humans
Ventricular Function
Arterial Pressure
Prospective Studies
Contraindication
Aged
business.industry
Cardiac function
10060 Epidemiology, Biostatistics and Prevention Institute (EBPI)
Postreperfusion syndrome
Middle Aged
Echocardiography, Doppler, Color
Anesthesiology and Pain Medicine
Blood pressure
Cardiology
Cytokines
Female
2703 Anesthesiology and Pain Medicine
business
Echocardiography, Transesophageal
Research Article
Subjects
Details
- ISSN :
- 14712253
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- BMC Anesthesiology
- Accession number :
- edsair.doi.dedup.....807f0ce63698cfc47e7eeadbb18f333f