Evaluation of the right ventricular ejection fraction during orthotopic liver transplantation under propofol anaesthesia

• Published in: British journal of anaesthesia : BJA Vol. 101; no. 2; pp. 161 - 165
• Main Authors: Gouvêa, G., Diaz, R., Auler, L., Martinho, J.M.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.08.2008; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Adult; anaesthetic techniques; anaesthetic techniques, i.v. infusion; anaesthetics i.v; anaesthetics i.v., propofol; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Intravenous - pharmacology; Biological and medical sciences; cardiopulmonary; Female; Hemodynamics; Humans; i.v. infusion; liver; Liver Transplantation; Male; measurement techniques; measurement techniques, thermodilution; Medical sciences; Middle Aged; monitoring; monitoring, cardiopulmonary; Monitoring, Intraoperative - methods; propofol; Propofol - pharmacology; Stroke Volume - drug effects; Thermodilution; transplantation; Ventricular Function, Right - drug effects; anaesthetics i.v., propofol; liver, transplantation; anaesthetic techniques, i.v. infusion; measurement techniques, thermodilution; monitoring, cardiopulmonary; thermodilution; monitoring; transplantation; measurement techniques; Liver; i.v. infusion; liver; propofol; anaesthetic techniques; Thermodilution; anaesthetics i.v; General anesthetic; Measurement technique; Anesthesia; Ventricular ejection; Propofol; cardiopulmonary; Monitoring; Ejection fraction
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aen145

The right ventricular ejection fraction pulmonary artery catheter (RVEF-PAC) has been widely used to monitor the right ventricular (RV) function during orthotopic liver transplantation (OLT). However, the evaluation of the RVEF during this procedure during propofol anaesthesia has not been described. Twenty consecutive patients undergoing OLT without veno-venous bypass were studied. Anaesthesia was maintained with propofol, remifentanil and atracurium infusions. All patients were monitored with a modified pulmonary artery catheter (RVEF-PAC), which continuously measures the RVEF. Haemodynamic data were recorded at: baseline (TB), anhepatic stage (TA), and 1, 5, 10, and 30 min post-reperfusion of the graft. The baseline RVEF was decreased [40% (sd 6)] and remained so throughout the OLT. A biphasic pattern was revealed, with the RVEF reaching its lowest values during TA [34% (7)] and gradually returning toward baseline at T30 [39% (8)]. Clinical significant RV dysfunction did not occur. Although the baseline RVEF was decreased, it showed only minor alterations throughout the procedure, suggesting that the RV function is not significantly compromised during OLT under propofol anaesthesia.