Pericardial Effusion of Obscure Origin

Muralimohan, Ramya; Delu, Adam; Ma, Thomas

doi:10.1007/s10620-014-3430-x

Cited by 2 publications

(1 citation statement)

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“…Pericardial effusion is reported to be common in cirrhotic patients, with a prevalence of 4–10% and up to 63% in decompensated cirrhosis. The pathophysiology of cirrhosis, including fluid retention, seems to play a role, and effusion is reported to resolve after LT [ 96 , 97 ]. The estimated size of effusion and presence of hemodynamic compromise should be evaluated using echocardiography [ 98 ].…”

Section: Other Clinical Considerations In Cirrhotic Patientsmentioning

confidence: 99%

Cardiovascular manifestation of end-stage liver disease and perioperative echocardiography for liver transplantation: anesthesiologist’s view

Han¹,

Park

Hong

et al. 2022

Anesth Pain Med

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Liver transplantation (LT) is the curative therapy for decompensated cirrhosis. However, anesthesiologists can find it challenging to manage patients undergoing LT due to the underlying pathologic conditions of patients with end-stage liver disease and the high invasiveness of the procedure, which is frequently accompanied by massive blood loss. Echocardiography is a non-invasive or semi-invasive imaging tool that provides real-time information about the structural and functional status of the heart and is considered to be able to improve outcomes by enabling accurate and detailed assessments. This article reviews the pathophysiologic changes of the heart accompanied by cirrhosis that mainly affect hemodynamics. We also present a comparative review of the diagnostic criteria for cirrhotic cardiomyopathy published by the World Congress of Gastroenterology in 2005 and the Cirrhotic Cardiomyopathy Consortium in 2019. This article discusses the conditions that could affect hemodynamic stability and postoperative outcomes, such as coronary artery disease, left ventricular outflow tract obstruction, portopulmonary hypertension, hepatopulmonary syndrome, pericardial effusion, cardiac tamponade, patent foramen ovale, and ascites. Finally, we cover a number of intraoperative factors that should be considered, including intraoperative blood loss, rapid reaccumulation of ascites, manipulation of the inferior vena cava, post-reperfusion syndrome, and adverse effects of excessive fluid infusion and transfusion. This article aimed to summarize the cardiovascular manifestations of cirrhosis that can affect hemodynamics and can be evaluated using perioperative echocardiography. We hope that this article will provide information about the hemodynamic characteristics of LT recipients and stimulate more active use of perioperative echocardiography.

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Section: Other Clinical Considerations In Cirrhotic Patientsmentioning

confidence: 99%