During liver transplantation, due to the complexity of the operation and abnormal coagulation function, there may be a large amount of bleeding and corresponding blood transfusion. Excessive blood transfusion will increase pulmonary complications and affect the prognosis. Infusion management to reduce bleeding is a very important issue in liver transplant surgery. Restrictive infusion management can effectively reduce the amount of bleeding in liver transplantation, but it remains unclear whether it will cause sequelae in other major organs. The investigators plan to study different infusion goals and strategies in liver transplant surgery using a randomized group model, using the PiCCO (Pulse Contour Cardiac Output) cardiopulmonary volume monitor, and setting the stroke volume variation (SVV) as the macroscopic circulation.The purpose of this study was to divide it into restrictive and liberal groups to explore the impact on liver transplantation bleeding volume and inflammatory response as well as postoperative lung and renal function, and to collect statistics on clinical care and postoperative sequelae (pulmonary liver, renal function impairment, etc.) in order to develop the most appropriate infusion management strategy in liver transplantation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
60
Fluid challage to keep stroke volume variation \< 10%
Fluid challage to keep stroke volume variation \< 18%
National Taiwan University Hospital
Taipei, Taiwan
RECRUITINGblood loss intraoperatively
blood loss intraoperatively in liver transplant
Time frame: during the operation
Lung injury biomarker
serum Clara Cell Protein (CC16)
Time frame: from biginning of the operation to postoprative day 1
Kidney injury biomarker
serum Neutrophil Gelatinase Associated Lipocalins (NGALs)
Time frame: from biginning of the operation to postoprative day 1
Influammatory reponses
IL-6
Time frame: from biginning of the operation to postoprative day 1
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