The change of respiratory compliance before and after removal of ascites in living donor liver transplantation.
BACKGROUND
The study's purpose was to evaluate the effects of total removal of the asictes through laparotomy on the lung function of adult patients undergoing living donor liver transplantation.


METHODS
One hundred eleven patients were reviewed retrospectively. Patients were grouped into 3 groups: GI had ascites <1000 mL, GII between 1000 and 4000 mL, and GIII >4000 mL. The respiratory compliance (RC), end-tidal carbon dioxide (EtCO2), peak and plateau airway pressures, tidal volume, and ventilator modes used were compared from 5 minutes before to 20 minutes after laparotomy, by using linear regression and repeated measurements. The changes in the RC among groups were tested using one-way analysis of variance (ANOVA), whereas the changes in percentage of the RC in the same group were tested using paired Student t test.


RESULTS
The changes in RC before and 10 minutes after laparotomy and total removal of the ascites were 45 ± 12 to 47 ± 13, 39 ± 9 to 43 ± 6, and 24 ± 8 to 43 ± 12 mL/cm H2O for GI, GII, and GIII, respectively. Linear regression analysis showed that the R(2) of the RC 20 minutes after removal of the ascites was 0.645. Pressure cycled ventilation (PCV) used in GIII significantly increased the tidal volume and low end tidal CO2 after laparotomy.


CONCLUSIONS
Removal of the ascites in patients undergoing living donor liver transplantation (LDLT) tended to improve the RC in all groups, but significant change was only noted in patients with massive ascites (GIII). Resetting of the ventilator is required to prevent hyperventilation when the PCV mode is used in GIII.
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
T-H
TH
Shih
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
S-C
SC
Yang
Department of Liver Transplantation Program and Surgery, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
C-L
CL
Chen
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
C-H
CH
Wang
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
K-W
KW
Cheng
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
C-J
CJ
Huang
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
B
B
Jawan
Department of Anesthesiology, Kaohsiung Chang Gung Memorial and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: shaochunwu@gmail.com.
S-C
SC
Wu
D000328:Adult; D001201:Ascites / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008170:Lung Compliance; D008875:Middle Aged