A comparison of intra-operative blood loss and acid-base balance between vasopressor and inotrope strategy during living donor liver transplantation: a randomised, controlled study.
Hong SH, Park CS, et al.Anaesthesia 2012; 67(10): 1091-1100.
Aims
To investigate whether intra-operative vasopressor infusion using phenylephrine is beneficial compared to inotrope infusion using dopamine andâ„or dobutamine during liver transplant surgery.
Interventions
Phenylephrine (starting dose of 0.3 µg/kg/min up to 0.4 µg/kg/min) versus a dopamine ℠dobutamine (starting dose of 2 µg/kg/min after induction of anaesthesia and up to 5–8 µg/kg/min during surgery). In both groups, dosage was adjusted to maintain the mean arterial pressure >65 mmHg, along with adequate volume resuscitation.
Participants
76 patients with decompensated liver cirrhosis undergoing living donor liver transplantation
Outcomes
Outcomes included haemodynamics, acid–base balance, global tissue oxygenation, peri-operative data for hepatic and renal function, death, duration of mechanical ventilation, ICU stay, reoperation, postoperative bleeding, graft-related complications, vascular thrombosis, cardiovascular events, renal dysfunction and biliary complications.
Follow-up
30 days
CET Conclusions
Phenylephrine was compared to dopamine and/or dobutamine during live donor liver transplantation in 76 adult liver recipients. Blood loss was reduced in the phenylephrine group compared to the dopamine/dobutamine group (4.5L vs 6.1L). Correspondingly use of packed red cells (10.5 units vs 13.9 units) and FFP ( 9.6 units vs 12.8 units) were also reduced in this group. Lactate levels and use of bicarbonate were also lower in the phenylephrine group. Cardiac index, ICU stay and 30-day mortality did not differ between the groups.
Data analysis
Strict intention-to-treat analysis
Trial registration
Not reported