Fabes, J;
Spiro, M;
Research Group, RFP;
(2021)
Prospective Cohort Study Assessing the Use of Peripheral Saphenous Venous Pressure Monitoring as a Marker of the Transcaval Venous Pressure Gradient in Liver Transplant Surgery.
Experimental and Clinical Transplantation
, 19
(12)
pp. 1291-1297.
10.6002/ect.2021.0288.
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Abstract
Objectives: Assessment of the transcaval venous pressure gradient, the central venous to inferior vena caval pressure, assists anesthetists and surgeons in management of liver transplant recipients. Traditionally, this entails insertion of a femoral central line with increased patient risk and health care cost. Here, we assessed the ability of a saphenous vein cannula to act as a surrogate for the femoral central line as a means to assess the transcaval pressure gradient in a safer and less invasive manner. / Materials and Methods: A prospective cohort of 22 patients undergoing liver transplant underwent saphenous vein cannulation in addition to insertion of a femoral and internal jugular central venous catheter. Data were collected throughout each phase of surgery to assess the central, femoral, and saphenous vein pressures; results of a range of relevant physiological and ventilatory data were also collected. / Results: The primary outcome, the correlation between saphenous and femoral venous pressure throughout surgery, was acceptable (r2 = 0.491, P < .001). During the anhepatic phase of surgery, this correlation improved (r2 = 0.912, P < .001). The correlation between the femoral to central venous pressure and saphenous to central venous pressure gradients was also reasonable throughout surgery (r2 = 0.386, P < .001), and this correlation was significantly stronger during the anhepatic phase (r2 = 0.935, P < .001). / Conclusions: Saphenous venous pressure, provided by peripheral cannulation, provided a reliable, less invasive, and safer alternative to femoral central line insertion for determination of the transcaval pressure gradient during the anhepatic phase of liver transplant.
| Type: | Article |
|---|---|
| Title: | Prospective Cohort Study Assessing the Use of Peripheral Saphenous Venous Pressure Monitoring as a Marker of the Transcaval Venous Pressure Gradient in Liver Transplant Surgery |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.6002/ect.2021.0288 |
| Publisher version: | https://doi.org/10.6002/ect.2021.0288 |
| Language: | English |
| Additional information: | This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Central venous pressure, Hemorrhage, Inferior vena cava |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10138746 |
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