Perioperative intravascular volume management for liver transplantation
Amr Mohamed Mahmoud Mohamed;
Abstract
Body fluids are divided into two major compartments; intracellular and extracellular :(Kathryn ,2001 )
Intracellular Compartment consists of all liquid within the cell membranes of the body and is the largest fluid compartment.Extracellular Compartment.is not a homogenous compartment. It is composed of interstitial fluid , plasma, and transcellular water.(Toto, 1998 )
A dynamic relationship exists between the extracellular and intracellular fluid compartments. The compartments are kept separate by the structural and functional integrity of cell membranes. Both passive and active processes regulate the movement of water and solutes across the cell membrane.(Kathryn,2001 )
IV fluids are calssified into : crystalloids , colloids and blood and blood products :( Awad et al.,2008)
crystalloid solutions better preserve diuresis and renal function than colloids in the critically ill (Bayer et al.,2011 ) , but not in healthy volunteers (Lobo et al.,2010 ) , probably by a fall in plasma colloid osmotic pressure promoting glomerular filtration.(James et al.,2011 ).
Colloids are considered to have a greater intravascular persistence when compared to crystalloids.(Martino et al.,2007 ) , Colloids have certain general characteristics which determine their behavior in the intravascular compartment. These, along with some other characteristics of the available colloids, are shown in
•Molecular weight (MW): Two molecular
weights are quoted for colloid solutions:
•Mw : Weight average molecular weight
•Mn : Number average molecular weight
In cirrhosis ,thrombocytopenia is a frequent finding, with platelet counts usually ranging between 30 to 109/L.prothrombin time and partial thromboplastin time are consistently prolonged because multiple coagulation factors are low in plasma in proportion to the degree of compromised protein synthetic capacity of the liver. Plasma hyperfibrinolysis is reported in cirrhosis on the basis of the increase of tissue plasminogen activator and decrease of the naturally occurring inhibitors of plasmin. (Mammen , 1994 )
As regard liver transplantation operation ; it involves three phases :the dissection phase , the anhepatic phase and the reperfusion phase .Each of these phases has its
Intracellular Compartment consists of all liquid within the cell membranes of the body and is the largest fluid compartment.Extracellular Compartment.is not a homogenous compartment. It is composed of interstitial fluid , plasma, and transcellular water.(Toto, 1998 )
A dynamic relationship exists between the extracellular and intracellular fluid compartments. The compartments are kept separate by the structural and functional integrity of cell membranes. Both passive and active processes regulate the movement of water and solutes across the cell membrane.(Kathryn,2001 )
IV fluids are calssified into : crystalloids , colloids and blood and blood products :( Awad et al.,2008)
crystalloid solutions better preserve diuresis and renal function than colloids in the critically ill (Bayer et al.,2011 ) , but not in healthy volunteers (Lobo et al.,2010 ) , probably by a fall in plasma colloid osmotic pressure promoting glomerular filtration.(James et al.,2011 ).
Colloids are considered to have a greater intravascular persistence when compared to crystalloids.(Martino et al.,2007 ) , Colloids have certain general characteristics which determine their behavior in the intravascular compartment. These, along with some other characteristics of the available colloids, are shown in
•Molecular weight (MW): Two molecular
weights are quoted for colloid solutions:
•Mw : Weight average molecular weight
•Mn : Number average molecular weight
In cirrhosis ,thrombocytopenia is a frequent finding, with platelet counts usually ranging between 30 to 109/L.prothrombin time and partial thromboplastin time are consistently prolonged because multiple coagulation factors are low in plasma in proportion to the degree of compromised protein synthetic capacity of the liver. Plasma hyperfibrinolysis is reported in cirrhosis on the basis of the increase of tissue plasminogen activator and decrease of the naturally occurring inhibitors of plasmin. (Mammen , 1994 )
As regard liver transplantation operation ; it involves three phases :the dissection phase , the anhepatic phase and the reperfusion phase .Each of these phases has its
Other data
| Title | Perioperative intravascular volume management for liver transplantation | Other Titles | ادارة الحجم الوعائي اثناءعملية زراعة الكبد | Authors | Amr Mohamed Mahmoud Mohamed | Issue Date | 2014 |
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