Relationship between postoperative intra-abdominal hypertension and fluid management during liver transplantation / 中华器官移植杂志

ABSTRACT

Objective To study the correlation between fluid management during liver transplantation and postoperative intra-abdorninal hypertension (IAH),and the correlation between intra-abdominal pressure and hemodynamics during liver transplantation.Method From Sep.2008 to Sep.2014,95 cases were admitted to ICU following liver transplantation were enrolled.All recipients were given abdominal color ultrasound examinations,and the IAH was measured.The preoperative Child-Pugh score,total operating time,anhepatic phase time,intraoperative blood loss,crystal solution input,colloidal fluid input,red blood cell infusion,plasma infusion,intraoperative total fluid input,intraoperative fluid input per h,and urinary volume per h and their correlation with postoperative IAH were analyzed by the Logistic regression method.The relationship between hemodynamics data and IAH intra-abdominal pressure was analyzed by the correlation analysis of two variables.Result IAH occurred in 18.94％ (18/95) recipients at 72nd h after operation.Fluid input per h (＞2000 ml/h) was risk factor (B=1.62;P＜0.05;OR=5.07,95％ CI1.41-18.23) of IAH.Urinary volume per h (＜200 ml/h) is risk factor (B=-3.21 ;P＜0.01OR =0.04,95％ CI0.01-0.18) of IAH.There was correlation between hepatic artery peak flow velocity (r =0.83,P＜0.01),portal vein peak flow velocity (r =-0.182,P＜0.05),and retrohepatic inferior vena cava peak flow velocity (r=-0.184,P＜0.05) with IAH.Conclusion Fluid input per h should be controlled in a low level and urinary volume per h should be increased in order to prevent IAH.There is correlation between hepatic artery peak flow velocity,portal vein peak flow velocity and retrohepatic inferior vena cava peak flow velocity with IAH.