Prevalencia de hipertensão pulmonar no periodo peri-operatorio de pacientes submetidos a transplante de figado
AUTOR(ES)
Cristina Aparecida Veloso
DATA DE PUBLICAÇÃO
2004
RESUMO
Pulmonary hypertension (PH) [mean pulmonary arterial pressure, mPAP>25mmHg] is frequently found during the post-operative period (post-OP) of liver transplantation (LT). Objective. To compare respiratory function, ICU length of stay (LOS) and 30th day survival rate in patients evolving with PH with those not developing it, during the post-OP of LT. Methods. 57 patients undergoing LT between January 1999 and December 2000 were divided in two groups: Group 1 (G1; n=26): without PH; and Group 2 (G2; n=31): with moderate PH. In the pre-OP Child-Pugh?s classification, pulmonary function tests, mPAP and PA-aO2 were recorded. During the intra-OP, hot and cold ischemia times and the amount of blood transfusion were evaluated, while mPAP, PaO2/FiO2 ratio, the weaning time, ICU LOS and the 30th day survival rate were considered in post-OP. Results. mPAP in early post-OP was 21±13 mmHg and 32±4 mmHg in G1 and G2, respectively (P<0.0001). PaO2/FiO2 was 310±82 mmHg in G1 and 272±84 mmHg in G2 (P =0.48). In G1 and G2, 77% and 74% of the patients, respectively, were successfully weaned in the first 24h post-OP (P=0.10). ICU LOS was 4,7 (1,9-45,8) days in G1 and 4,3 (1,9-11,8) days in G2 (P=0.36). The 30th day survival rate was 20/26 (77%) in G1 and 26/31 (84%) in G2 (P=0.44). Conclusion. Our data indicate that a moderate pulmonary hypertension in the early post-OP of LT can?t be considered an additional risk factor for pulmonary dysfunction and increased ICU LOS or 30th day mortality rate
ASSUNTO(S)
cirrose hepatica circulação pulmonar hipertensão pulmonar complicações pos-operatorias
ACESSO AO ARTIGO
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