Association between Hepatic Venous Congestion and Adverse Outcomes after Cardiac Surgery.

Csaba Eke, András Szabó,Ádám Nagy, Balázs Szécsi,Rita Szentgróti, András Dénes, Miklós D Kertai,Levente Fazekas, Attila Kovács,Bálint Lakatos, István Hartyánszky,Kálmán Benke, Béla Merkely,Andrea Székely

Diagnostics (Basel, Switzerland)(2022)

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摘要
Of the 41 patients, 20 (48.7%) were males, and the median age of the patients was 65.9 years (IQR: 59.8-69.9 years). Retrograde VTI growth showed a correlation with positive fluid balance (0.89 (95% CI 0.785-0.995) c-index. After comparing the postoperative echocardiographic parameters of the two subgroups, right ventricular and atrial diameters were significantly greater in the "retrograde VTI growth" group. The ejection fraction and decrement in ejection fraction to preoperative parameters were significantly different between the two groups. ( = 0.001 and 0.003). Ventilation times were longer in the retrograde VTI group. The postoperative vs. baseline delta VTI ratio of the hepatic vein correlated with positive fluid balance, maximum central venous pressure, and ejection fraction. (B = -0.099, 95% CI = -0.022-0.002, = 0.022, B = 0.011, 95% CI = 0.001-0.021, = 0.022, B = 0.091, 95% CI = 0.052-0.213, = 0.002, respectively.) Conclusion: The increase of the retrograde hepatic flow during the first 24 h following cardiac surgery was associated with positive fluid balance and the decrease of the right ventricular function. Measurement of venous congestion or venous abdominal insufficiency seems to be a useful tool in guiding fluid therapy and hemodynamic management.
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关键词
Doppler ultrasound,cardiac surgery,fluid balance,hepatic venous flow
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