- 作者：F. Pugliese ; F. Ruberto ; K. Bruno ; S. Martelli ; S. Perrella ; A. Cappannoli ; A. D’ ; Alio ; T. Messina ; D. Summonti ; C. Pietropaoli ; M. Rossi ; G. Novelli ; P.B. Berloco ; P. Pietropaoli
- 关键词：Blood transfusion ; Evaluation of the professional practices ; Continuous medical training
- 刊名：Transplantation Proceedings
- 出版年：2007
- 期刊代码：252_00411345
- 类别：med
- 出版时间：July-August 2007
- 卷：39
- 期：6
- 页码：1886-1888
- 文件大小：56 K
ss="h4">Patients and Methods
We enrolled 40 patients of mean age 57 ± 16 years who underwent (OLT). They were randomly divided into two double blinded groups; continuous fenoldopam (0.06 mcg/kg per minute) or placebo infusion. Hemodynamics, gastric tonometry, urine output, renal function parameters, and diuretics use were collected during selected phases of the surgery and postoperatively every 12 hours for 72 hours in the intensive care unit.
ss="h4">Results
No significant differences were observed between the two groups concerning hemodynamics, though in the fenoldopam group we observed increased splanchnic perfusion during the whole study period but particularly after arterial unclamping (pHi 7,31 ± 0.04 vs 7.28 ± 0.05; P < .05) and at 48 hours after surgery (pHi 7.49 ± 0.15 vs 7.39 ± 0.15; P < .05). Creatinine and blood urea nitrogen values were slightly higher in the placebo group, but this data did not reach statistical significance, while higher doses of furosemide were administered to the placebo group to maintain a urinary output over 200 mL/hour during the whole study.
ss="h4">Discussion
In this study we observed that continuous fenoldopam infusion (0.06 mg/kg per minute) improved splanchnic perfusion without affecting systemic pressure.
ss="h4">Conclusion
Patients undergoing OLT have altered splanchnic perfusion related to cirrhosis, surgical manipulation, and fluid shifts during and after surgery. The use of a splanchnic vasodilator drug improved outcomes in these patients.