Original scientific paper
https://doi.org/10.21860/medflum2018_192886
Perioperative volume replacement therapy for orthopic liver transplantation-observational, retrospective study
Jadranka Pavičić Šarić
orcid.org/0000-0003-4124-8056
; Klinička bolnica Merkur, Odjel anestezije, reanimatologije i intenzivnog liječenja, Zagreb, Hrvatska
Branislav Kocman
; Klinička bolnica Merkur, Odjel anestezije, reanimatologije i intenzivnog liječenja, Zagreb, Hrvatska
Denis Guštin
; Klinička bolnica Merkur, Odjel anestezije, reanimatologije i intenzivnog liječenja, Zagreb, Hrvatska
Jelena Zenko
; Klinička bolnica Merkur, Odjel anestezije, reanimatologije i intenzivnog liječenja, Zagreb, Hrvatska
Vanja Vončina
; Klinička bolnica Merkur, Odjel anestezije, reanimatologije i intenzivnog liječenja, Zagreb, Hrvatska
Petra Ožegović
; Klinička bolnica Merkur, Odjel anestezije, reanimatologije i intenzivnog liječenja, Zagreb, Hrvatska
Abstract
Aim: Significant fluid losses occur during liver transplantation, which need to be replaced. In this study, we analyzed whether fluid replacement strategies during liver transplantation have changed over a five-year period.
Materials and Methods: In this observational, retrospective study, we collected data on 155 patients who underwent liver transplantation at the University Hospital «Merkur», 79 in 2015 and 76 in 2010. We analyzed total blood loss, total volume of replaced fluids and the volume of crystalloids, colloids, erythrocyte concentrates, fresh frozen plasma and platelets applied. We employed the Student t-test for statistical analysis.
Results: Total blood losses (ml) in 2015 and 2010 were: 6526± 4194 and 11122± 6685, respectively, P<0,001. Volumes of replaced fluids (ml) in 2015 and 2010 were following: total fluid volume 9640± 6017 and 18433± 7282, P< 0,001; crystalline 5077± 1443 and 5674± 2326, P=0,055; colloids 1853± 814 and 2244± 1188, P=0,018 ; autologous blood 1097± 1160 and1927± 2608, P=0,011; homologous blood 1293± 1247 and 2979± 2196, P<0,001; fresh frozen plasma 2244± 1523 and 5429± 1954, P<0,001; platelets 349± 387 and 426± 313, P=0,176.
Conclusions: This study showed a significant reduction in total fluid replacement, as well as in replacement of colloids, blood transfusion and fresh frozen plasma during liver transplantation over a period of five years. A possible explanation is a more restrictive perioperative fluid replacement strategy employed with the aim of reducing adverse effects of volume overload as well as a growing experience acquired over a number of successful years in transplantation medicine.
Keywords
intraoperative fluid managment; liver transplantation; surgical intensive care
Hrčak ID:
192886
URI
Publication date:
1.3.2018.
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