Can we predict pulmonary wedge pressure from central venous pressure in hepatic transplantation?

• DOI: 10.1186/cc2236
• Publication Date: 2003-06-26T06:33:17Z
• Authors: FS Machado; ACKB Amaral; GL Büchele; ACB Sogayar; HMC DiBenedetto; GL Oliveira; MC Souza; CJ Fernandes; V Michels; E Silva; E Knobel
• Keywords: Pulmonary wedge pressure; Wedge (geometry); Pulmonary arterial pressure

Introduction Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI).As an attempt dampen steroids have been perioperatively administered patients.Macrophage migration inhibitory factor (MIF), regulator the endotoxin receptor, implicated in pathogenesis ALI.We previously detected peak circulating levels MIF, 6 hours post CPB.Experimental data shown that may induce MIF secretion by mononuclear cells.This study aims correlate assayed CPB intensity pulmonary dysfunction, analysing impact perioperative steroid administration. MethodsWe included patients submitted cardiac CPB, electively started morning, performed same team under standard technique except for addition methylprednisolone (15 mg/kg) priming solution from group MP (n = 37), but not remaining -group NS 37).MIF were at anesthesia induction, 3, 6, and 24 after CPB.A weaning protocol fast track strategy was adopted, indicators organ dysfunction therapeutic intervention registered during first 72 postoperative.Results Levels correlated directly duration mechanical ventilation (P 0.014, rho 0.282) inversely PaO 2 /FiO ratio 0.0021, -0.265).No difference noted between groups.The higher 0.005) (7.92 ± 6.0 hours), compared (4.92 3.6 hours). ConclusionCirculating are performance.Immunosuppressive doses did affect be prolonged ventilation.