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Is positive end-expiratory pressure suitable for liver recipients with a rescue organ offer?

Abstract：

PURPOSE:Rescue organ offers may help to overcome the organ shortage. However, because of initial poor liver function, the recipient may develop a severe lung injury with the requirement for higher positive end-expiratory pressure (PEEP) levels to achieve adequate oxygenation. Positive end-expiratory pressure has been associated with perfusion impairment in the hepatosplanchnic area. We assessed the effects of increased PEEP levels on systemic hemodynamic and liver perfusion in liver transplantation (LT) patients with a rescue organ. METHODS:Twenty-four LT recipients of a rescue organ offer were enrolled. All patients were postoperatively mechanically ventilated with biphasic positive airway pressure, and 3 different PEEP levels (0, 5, 10 mbar) were randomly set within 4 hours after admission at the intensive care unit. Systemic hemodynamic parameters were recorded using a pulmonary artery catheter; and flow velocities of the hepatic artery, portal vein, and right hepatic vein were measured using Doppler. RESULTS:Positive end-expiratory pressure of 10 mbar did not impair the systemic hemodynamic. Flow velocities in the right hepatic vein, the portal vein, and the hepatic artery were not influenced by PEEP. CONCLUSION:Our study demonstrates that PEEP up to 10 mbar did not impair the liver outflow in recipients with a rescue organ offer.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Saner FH,Olde Damink SW,Pavlaković G,Sotiropoulos GC,Radtke A,Treckmann J,Beckebaum S,Cicinnati V,Paul A

doi

10.1016/j.jcrc.2009.11.002

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

477-82

issue

3

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(09)00277-9

journal_volume

25

pub_type

杂志文章

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