Loading…

Does Preoperative Beta-blocker Use Influence Intraoperative Hemodynamic Profile and Post-operative Course of Liver Transplantation?

Abstract Objective We compared the intraoperative hemodynamic profiles and outcomes of liver transplant (LT) patients receiving preoperative beta-blockers for portal hypertension with those of patients not receiving beta-blockers. Methods Beat-to-beat hemodynamic data were recorded with the use of a...

Full description

Saved in:
Bibliographic Details
Published in:Transplantation proceedings 2016, Vol.48 (1), p.111-115
Main Authors: Milan, Z, Taylor, C, Armstrong, D, Davies, P, Roberts, S, Rupnik, B, Suddle, A
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objective We compared the intraoperative hemodynamic profiles and outcomes of liver transplant (LT) patients receiving preoperative beta-blockers for portal hypertension with those of patients not receiving beta-blockers. Methods Beat-to-beat hemodynamic data were recorded with the use of a lithium dilution cardiac output monitor, including heart rate (HR), cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), SVR index, mean arterial pressure, stroke volume (SV), and SV index. Perioperative data included age, sex, etiology of cirrhosis, Model of End-Stage Liver Disease score, warm and cold ischemia times, and intraoperative blood and blood products replacement. Postoperative data included Acute Physiology and Chronic Health Evaluation II score, Intensive Care National Audit and Research Centre (ICNARC) score, length of intensive care unit stay, renal replacement treatment, and mortality. Results After exclusion, 215 patients not receiving and 93 patients receiving beta-blockers for portal hypertension were included. There was no significant difference between groups in demographic data. HR, CO, and CI were significantly lower in the beta-blocker group ( P  = .0001). Regarding outcomes, the ICNARC score was significantly higher in the beta-blocker group ( P  < .05). Conclusions Preoperative administration of beta-blockers attenuates the hyperdynamic circulation in LT patients; this is clearly seen through a reduction in intraoperative CO, CI, and HR. This decreased hyperdynamic state was not shown to relate to outcomes in any of the variables except for a higher ICNARC score reported in the group treated with beta-blockers.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2015.12.027