Bente Marei Wolpert, David Jonas Rothgerbe, Ann Kristin Rosner, Malte Brunier, Robert Kuchen, Patrick Schramm, Eva-Verena Griemert
Abstract
Cerebrovascular autoregulation in patients with acute and chronic liver failure is often impaired, yet an intact autoregulation is essential for the demand-driven supply of oxygenated blood to the brain.
Introduction
Dynamic cerebrovascular autoregulation (dCA) is often impaired in patients with acute and chronic liver failure [1, 2]. An intact dCA is essential for the demand-driven supply of oxygenated blood to the brain.
Material and Methods
The study was approved by the local ethics committee of Rhineland-Palatinate, Germany (approval number: 837.041.10 (7050)) and registered at ClinicalTrials.gov (NCT01597102). As this was an observational cohort pilot study, the STROBE protocol was applied [12].
Result
In total, 24 patients undergoing LTX were initially included, with data from 20 patients being available for analysis (7 females and 13 males).
Discussion
The primary outcome was defined as difference of the integrity of dCA between the phases of LTX. For a considerable time, dCA was often evaluated in the time domain through the calculation of the Mxa (autoregulation index) as an indicator of its integrity [19].
Conclusion
In this observational pilot study, the obtained results provide a very subtle indication of a more intact dCA during the preparation phase.
Citation: Wolpert BM, Rothgerber DJ, Rosner AK, Brunier M, Kuchen R, Schramm P, et al. (2024) Evaluation of dynamic cerebrovascular autoregulation during liver transplantation. PLoS ONE 19(7): e0305658. https://doi.org/10.1371/journal.pone.0305658
Editor: Yuri Longatto Boteon, Hospital Israelita Albert Einstein, BRAZIL
Received: August 17, 2023; Accepted: June 3, 2024; Published: July 26, 2024
Copyright: © 2024 Wolpert et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: The authors received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: ABP, arterial blood pressure; ASA, American Society of Anesthesiologists; dCA, dynamic cerebrovascular autoregulation; CAM-ICU, Confusion Assessment Method for the Intensive Care Unit; CBF, cerebral blood flow; CBv, cerebral blood velocity; CI, cardiac index; CO, cardiac output; CO2, carbon dioxide; CPP, cerebral perfusion pressure; HE, hepatic encephalopathy; HR, heart rate; ICP, intracranial pressure; ICU, intensive care unit; INR, international normalized ratio; LTX, liver transplantation; MAC, minimum alveolar anesthetic concentration; MAP, mean arterial pressure; MCBv, mean cerebral blood velocity; MELD, model for the end stage of liver disease; Mxa, autoregulation index; PaCO2, arterial carbon dioxide partial pressure; rSO2, regional oxygen saturation; TCD, transcranial doppler sonography
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0305658#abstract0
