Intraoperative validation of a new system for invasive continuous cardiac output measurement

D’Ancona, Giuseppe; Parrinello, Matteo; Santise, Gianluca; Biondo, Domenico; Pirone, Francesco; Sciacca, Sergio; Turrisi, Marco; Pilato, Michele

doi:10.1007/s00134-009-1422-7

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…TTFM reliably detects portal venous and arterial blood flow after the reperfusion of hepatic grafts. Previous studies have indicated that this method generates reproducible and valid data 16‐18, 24. Therefore, the aim of the present study was to determine the effects of portal venous, arterial, and total blood flow on postoperative organ function, complication rates, and graft survival.…”

Section: Discussionmentioning

confidence: 96%

“…Portal and hepatic blood flow was measured with TTFM at the end of the surgery (Medi‐Stim AS, Oslo, Norway). This method generates valid data and provides reliable measurements that are independent of the examiner's experience as well as environmental conditions that cannot be controlled, such as the measurement angle, blood temperature, and hematocrit level 16‐18…”

Section: Methodsmentioning

confidence: 99%

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Arterial blood flow predicts graft survival in liver transplant patients

et al. 2011

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Proper liver perfusion is essential for sufficient organ function after liver transplantation. The aim of this study was to determine the effects of portal and arterial blood flow on liver function and organ survival after liver transplantation. The arterial and portal venous blood flow was measured intraoperatively by transit time flow measurement after reperfusion for 290 consecutive liver transplants. The graft survival, hepatic cell damage (alanine aminotransferase and aspartate aminotransferase), and liver function (prothrombin ratio and bilirubin) were determined. Grafts were stratified into groups according to arterial blood flow measurements [<100 mL/minute for arterial blood flow group I (ART I), 100-240 mL/minute for ART II, and 240 mL/minute for ART III] and portal venous blood flow measurements (<1300 mL/minute for portal venous blood flow group I and 1300 mL/minute for portal venous blood flow group II). With multivariate analysis, the impact of blood flow on graft survival was determined, and potential confounders were considered. Decreased portal venous blood flow was associated with significantly less organ survival in univariate analysis but not in multivariate analysis. In contrast, the arterial blood flow was significantly correlated with organ survival after liver transplantation in univariate and multivariate analyses [hazard rate ratio ¼ 2.5, confidence interval ¼ 1.6-4.1, P < 0.001, median survival ¼ 56.6 (ART I), 82.7 (ART II), or 100.7 months (ART III)]. Moreover, low arterial blood flow resulted in impaired postoperative organ function and higher rates of primary nonfunction. Biliary complications were not affected by blood flow. Other risk factors for graft failure that were identified by multivariate analysis included retransplantation, histidine tryptophan ketoglutarate solution versus University of Wisconsin solution, and donor treatment with epinephrine. Impaired arterial blood flow after reperfusion represents a significant predictor of primary graft nonfunction and is associated with impaired graft survival. Whether the intraoperative measurement of hepatic arterial flow is predictive of graft survival should be evaluated in a prospective trial.

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Arterial blood flow predicts graft survival in liver transplant patients

et al. 2011

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“…Dancona et al [28] tested a continuous cardiac output (CO) recording system that operates on the thermal conservation principle, and they compared it with the reference standard transit time flow measurement. There was a significant underestimation of CO with the continuously recording system, but it may be useful to detect trends over time.…”

Section: Devices and Techniquesmentioning

confidence: 99%

Year in review in Intensive Care Medicine 2009: II. Neurology, cardiovascular, experimental, pharmacology and sedation, communication and teaching

et al. 2010

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“…The measurement of intraoperative blood flow was performed with a flow metre VeriQ, based on measuring the transit time (MFTT) and Doppler technology. This system has been validated in previous studies and generates reproducible measurements[20-22].…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma staging systems: Hong Kong liver cancer vs Barcelona clinic liver cancer in a Western population

Lominchar

Orue-Echebarria

Martín

et al. 2019

WJH

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BACKGROUNDEarly allograft dysfunction (EAD) after liver transplantation (LT) is an important cause of morbidity and mortality. To ensure adequate graft function, a critical hepatocellular mass is required in addition to an appropriate blood supply. We hypothesized that intraoperative measurement of portal venous and hepatic arterial flow may serve as a predictor in the diagnosis of EAD.AIMTo study whether hepatic flow is an independent predictor of EAD following LT.METHODSThis is an observational cohort study in a single institution. Hepatic arterial blood flow and portal venous blood flow were measured intraoperatively by transit flow. EAD was defined using the Olthoff criteria. Univariate and multivariate analyses were used to determine the intraoperative predictors of EAD. Survival analysis and prognostic factor analysis were performed using the Kaplan-Meier and Cox regression models.RESULTSA total of 195 liver transplant procedures were performed between January 2008 and December 2014 in 188 patients. A total of 54 (27.7%) patients developed EAD. The median follow-up was 39 mo. Portal venous flow, hepatic arterial flow (HAF) and total hepatic arterial flow were associated with EAD in both the univariate and multivariate analyses. HAF is an independent prognostic factor for 30-d patient mortality.CONCLUSIONIntraoperative measurement of blood flow after reperfusion appears to be a predictor of EAD; Moreover, HAF should be considered a predictor of 30-d patient mortality.

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Intraoperative validation of a new system for invasive continuous cardiac output measurement

Abstract: Although TruCCOMS may significantly underestimate CO, measurement trends correlate with TTFM. For this reason, a negative trend in RV output should trigger more specific diagnostic procedures.

Cited by 5 publications

References 7 publications

Arterial blood flow predicts graft survival in liver transplant patients

Arterial blood flow predicts graft survival in liver transplant patients

Year in review in Intensive Care Medicine 2009: II. Neurology, cardiovascular, experimental, pharmacology and sedation, communication and teaching

Hepatocellular carcinoma staging systems: Hong Kong liver cancer vs Barcelona clinic liver cancer in a Western population

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