Risk Factors of Postoperative Acute Lung Injury Following Liver Transplantation

National Taiwan University

Status: Unknown

Conditions: Acute Lung Injury

Study type: Observational

Funder types: Other

Identifiers

NCT02412800

201412036RINC

Details and patient eligibility

About

Postoperative acute lung injury (ALI) during the first 72 hours after liver transplantation is not uncommon. Injury may occur because liver transplantation is often associated with prolonged operative time, large volumes of fluid administration and transfusion, as well as inflammatory responses related to ischemia-reperfusion injury. For more precise perioperative fluid and hemodynamic management, modern monitoring systems, such as the pulse contour cardiac output (PiCCO) system, have been devised and reported in recent years. The PiCCO system uses the thermodilution technique to determine the cardiac index (CI) and thoracic fluid indices such as the intrathoracic blood volume index (ITBVI), extravascular lung water index (EVLWI), and pulmonary vascular permeability index (PVPI), all of which may reflect pulmonary fluid and injury status. However, perioperative changes in thoracic fluid indices in liver transplantation and their associations with postoperative ALI are not yet clear. In this study, the investigators aimed to determine patterns of change in perioperative thoracic fluid indices and compare these changes in recipients who did or did not develop postoperative ALI. Furthermore, the investigators will also try to determine the potential risk factors following liver transplantation.

Enrollment: 250 estimated patients

Sex: All

Ages: 6 months to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• End stage liver disease receiving liver transplantation in NTUH.
• Age: 6 months old to 75 years old

Exclusion criteria

• history of pulmonary resection,
• chronic respiratory insufficiency
• cardiac dysfunction
• failure of the surgery.

Trial design

250 participants in 1 patient group

Acute lung injury

Description:

Postoperative acute lung injury was diagnosed according to the latest 2012 Berlin definition of acute respiratory distress syndrome by the PaO2/FiO2\< 300 and acute onset of bilateral infiltrates on the chest radiograph that were not fully explained by cardiac failure during postoperative day 1 to postoperative day 3.