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Postreperfusion syndrome: Hypotension after reperfusion of the transplanted liver

Aggarwal, S and Kang, Y and Freeman, JA and Fortunato, FL and Pinsky, MR (1993) Postreperfusion syndrome: Hypotension after reperfusion of the transplanted liver. Journal of Critical Care, 8 (3). 154 - 160. ISSN 0883-9441

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Abstract

Sixty-nine patients undergoing liver transplantation were evaluated to elucidate the relationship between hypotension and physiological changes seen on reperfusion of the grafted liver. Measured variables included hemodynamic profiles, core temperature, serum potassium, ionized calcium levels, arterial blood-gas tensions, and acid-base state. Measurements were taeen 60 minutes after skin incision (baseline), 5 minutes before reperfusion, and 30 seconds and 5 minutes after reperfusion. On the basis of changes in mean arterial pressure (MAP) patients were divided in two groups. Group 1 (n = 49) maintained MAP greater than 70% and group 2 (n = 20) had MAP less than 70% of the baseline value for at least 1 minute within 5 minutes after reperfusion. On reperfusion, changes common to both groups were 27% increase in cardiac filling pressures, 23% base deficit, and 30% serum potassium level and a decrease of 16% in cardiac output and 9% in temperature. Compared with group 1, group 2 had greater decrease in systemic vascular resistance (SVR) (1097 ± 868 and 741 ± 399 dyn · s-1. cm-5, respectively, P < .05) and higher potassium level (4.5 ± 0.8 and 5.3 ± 0.8 mmol/L,P < .05). Collectively in both groups, there was no correlation between MAP and physiological variables; however, there was a poor correlation with SVR (r = .32, P < .01). Reperfusion hypotension seen in group 2 patients correlated only with a decrease in systemic vascular resistance (r = .5, P < .05). Acute hyperkalemia, hypothermia, and acidosis do not appear to be major causes of reperfusion hypotension. © 1993.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Aggarwal, S
Kang, Y
Freeman, JA
Fortunato, FL
Pinsky, MRpinsky@pitt.eduPINSKY
Date: 1 January 1993
Date Type: Publication
Journal or Publication Title: Journal of Critical Care
Volume: 8
Number: 3
Page Range: 154 - 160
DOI or Unique Handle: 10.1016/0883-9441(93)90021-c
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0883-9441
PubMed ID: 8275160
Date Deposited: 01 Mar 2012 20:40
Last Modified: 04 Feb 2019 15:57
URI: http://d-scholarship.pitt.edu/id/eprint/11130

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