Postoperative two hemodynamics management strategies on the early impact of liver transplantation recipients / 中华器官移植杂志

ABSTRACT

Objective To investigate early postoperative impact on recipients after liver transplantation with the two hemodynamic management strategies by using the "gold standard" Swan-Ganz catheter and central venous catheter (CVC) to monitor hemodynamics and guide liquid and vasoactive drug therapy.Methods From May 2006 to January 2009,102 from 107 cases of liver transplantations in our hospital were randomly divided into two groupsPAC group (pulmonary artery Swan-Ganz catheter group,n = 52) and CVC group (n = 50 cases).Hemodynamic parameters were monitored.Results There was no significant difference in the general characteristics between two groups In PAC group and CVC group,the mortality during ICU stay was 7.7 % and 4 %; postoperative 28-day mortality was 11.5 % and 8 % ; the median mechanical ventilation time was 26.5 and 24 h; the median ICU stay was 2.5 and 2 days,respectively.There was no significant difference in the aforementioned parameters (P＞0.05).There was no significant difference in renal function and liver function before and 1,5 days after operation,and mean blood lactic acid level 1,2,and 3 days after operation between two groups (P＞0.05).In PAC group and CVC group,transient ventricular arrhythmias occurred in 26 cases and 2 cases Conclusion It is not a good strategy using "gold standard" Swan-ganz catheter to monitor hemynamic parameters and guide therapy after liver transplantation in ICU,and on the contrary,the application of "gold standard" Swan-ganz catheter increases incidence of transient ventricular arrhythmias.