Comparison of Hemodynamic Data obtained from a Pulmonary Artery Catheter vs. Esophageal Doppler during Liver Transplantation. |
Bon Nyeo Koo, Jong Yoep Kim, Kyung Bong Yoon, Sun Joon Bae, So Young Ban, Jong Ho Lee, Soon Ho Nam |
1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. nsh66@yumc.yonsei.ac.kr 2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. 3Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Suwon, Korea. |
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Abstract |
BACKGROUND The measurement of cardiac output is an essential part of anesthetic practice in patients undergoing liver transplantation. A thermodilution technique, using a pulmonary artery catheter is currently accepted as the gold standard in clinical practise. However, its use is associated with several limitations. METHODS An esophageal doppler monitor was compared with the thermodilution technique in 22 patients undergoing split graft transplantation from a living donor. Six measurement were taken during liver transplantation, 1) control, 2) dissection phase, 3) anhepatic phase, 4) reperfusion phase, 5) after hepatic artery anastomosis, and 6) end of surgery. RESULTS Significant difference were observed between the two measurement at all times studied with a strong correlation, except at the end of surgery (r > 0.4). CONCLUSIONS The use of esophageal doppler monitor results in cardiac output measurements which are considerably different from those obtained using thermodilution, but a strong correlation exists between two methods. Thus the use of esohageal monitoring can be recommended in patients undergoing liver transplantation for trend monitoring. |
Key Words:
cardiac output; esophageal doppler monitor; liver transplantation; pulmonary artery catheter |
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