J Clin Monit Comput - Intraoperative ICG plasma disappearance rate helps to predict absence of early postoperative complications after orthotopic liver transplantation.

Tópicos

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Resumo

Early postoperative complications after orthotopic liver transplantation (OLT) are a common problem in intensive care medicine. Adequate assessment of initial graft function remains difficult, however, plasma disaperance rate of indocyanine green (PDRICG) may have an additional diagnostic and prognostic value in this setting. We retrospectively evaluated the ability of intraoperative PDRICG values to predict absence of early postoperative complications in 62 subjects. PDRICG was measured non-invasively by pulse dye densitometry during surgery and was correlated with initial graft function. At the end of surgery, PDRICG was higher in patients without complications: 24.9?%?min(-1) (n?=?40) versus 21.0?%?min(-1), (n?=?22; p?=?0.034). An area under the ROC curve (AUROC) for PDRICG was 0.70, while the AUROC for pH, lactate and PT at ICU admission were 0.53, 0.50 and 0.46, respectively. The AUROC of serum bilirubin and PT at postoperative day 5 were 0.68 and 0.49, respectively. The optimal cut-off PDRICG value for predicting absence of development early postoperative complications was determined to be 23.5?%?min(-1) with 72.4?% sensitivity and 71.0?% specificity. Intraoperative point-of-care PDRICG measurement during OLT already predicts absence of early postoperative complications, better and earlier than clinically used laboratory parameters.

Resumo Limpo

earli postop complic orthotop liver transplant olt common problem intens care medicin adequ assess initi graft function remain difficult howev plasma disaper rate indocyanin green pdricg may addit diagnost prognost valu set retrospect evalu abil intraop pdricg valu predict absenc earli postop complic subject pdricg measur noninvas puls dye densitometri surgeri correl initi graft function end surgeri pdricg higher patient without complic min n versus min n p area roc curv auroc pdricg auroc ph lactat pt icu admiss respect auroc serum bilirubin pt postop day respect optim cutoff pdricg valu predict absenc develop earli postop complic determin min sensit specif intraop pointofcar pdricg measur olt alreadi predict absenc earli postop complic better earlier clinic use laboratori paramet

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