W. G. Logas

Effects of continuous arteriovenous hemofiltration on cardiopulmonary abnormalities during anesthesia for orthotopic liver transplantation

Orthotopic liver transplantation (OUT) often involves large blood loss and replacement, aswell as administration of large amounts of blood products to correct coagulation defects. Renal free water excretion is often impaired in end-stage liver disease and not responsive to routine diuretic therapy, predisposing these patients to accumulation of extravascular lung water. The effects of the intraoperatives use of continuous arteriovenous hemofiltration (CAVH) on cardiopulmonary and oxygen transport variables were studied in ten patients during and 24 hours after OLT. CAVH prevented increases in pulmonary shunt fraction while decreasing PEEP and FIO2 requirements. Pulmonary compliance was significantly higher after operation in patients receivingCAVH. Before surgical dissection, hemodynamic effects of CAVH were minimal. Postoperatively, patients having CAVH had lower cardiac filling pressures and more normal systemic vascular resistance than did patients not having CAVH. These data suggest that CAVH may be a useful intraoperative technique for patients with impaired renal function undergoing liver transplantation.

Oxygen consumption and mixed venous oxygen saturation monitoring during orthotopic liver transplantation.

AbstractMixed venous oxygen saturation

Thromboelastography used for detection of perioperative fibrinolysis: A report of four cases

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PROSPECTIVE EVALUATION OF CONTINUOUS EPIDURAL NARCOTIC-BUPIVACAINE INFUSIONS IN 1000 POSTOPERATIVE PATIENTS

monitoring has been advocated for some critically ill patients. Patients with end-stage hepatic failure have oxygen consumption rates that are lower than normal. Using the Fick equation, oxygen consumption may be calculated if mixed venous and arterial oxygen tensions (and saturations), hemoglobin, and cardiac output are determined simultaneously. This report describes a unique pattern of changes in

EEG POWER ANALYSIS IS SUPERIOR TO FREQUENCY ANALYSIS FOR PREDICTING ADVERSE NEUROLOGIC OUTCOME AFTER OPEN HEART SURGERY FOR NARCOTIC ANESTHESIA

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Minimal PEEP May Be “Best PEEP”

and oxygen consumption in 7 patients undergoing liver transplantation. A previous study correlated plasma carbohydrate (glucose) levels with early hepatic graft survival. After induction, the 7 patients reported here had low oxygen consumption and high