Predictors of alkalosis after liver transplantation.
Predictors of alkalosis after liver transplantation.
复制标题
肝移植后碱中毒的预测因素。
DOI：
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发表时间：
2002
影响因子：
13.2
通讯作者：
D. Roth
中科院分区：
文献类型：
--
作者：
G. Contreras;G. Garces;J. Reich;D. Banerjee;Larry Young;C. Cely;F. Gadalean;G. Perez;D. Roth
背景
代谢性肝硬化是原位肝移植术后常见的并发症。
方法
该研究的目的是确定285次OLTS后与MA相关的因素。MA定义为总二氧化碳含量≥ 30 mEq/L，115例患者（40%）在术后前3天内发生MA。
结果
通过单因素分析，MA患者术前二氧化碳含量较高（24.4 +/- 3 vs 22.9 +/- 2.9 mEq/L; P < 0.0001）和红细胞压积（35% +/- 5%对33% +/- 6%; P < 0.02），但肌酐较低（0.9 +/- 0.5对1.2 +/- 1.2 mg/dL; P < 0.001）和血尿素氮水平（15 +/- 12对19 +/- 17 mg/dL; P < 0.001）与对照组相比。与对照组相比，MA患者术中给予的柠檬酸盐更多（6.2 +/- 5.2 vs 4.5 +/- 3.6 mEq/kg体重; P < 0.02）。与对照组相比，MA患者术后钾水平（3.7 +/- 0.4 vs 4 +/- 0.5 mEq/L; P < 0.0001）和累积液体平衡（-0.66 +/- 1.87 vs +0.003 +/- 3.9 L; P < 0.007）较低。经多因素分析，术前二氧化碳含量（比值比，1.19; 95%置信区间[CI]，1.08 - 1.31/mEq/L），肌酐水平（比值比，0.61; 95% CI，0.39 - 0.96/mg/dL），术中给予柠檬酸盐（比值比，3.35; 95% CI，1.71 - 6.53/10 mEq/kg体重）和术后钾水平（比值比，0.32; 95% CI，0.18 - 0.57/mEq/L）与MA独立相关。MA与住院死亡率增加无关（7.8% vs 8.2%，MA vs对照）。然而，MA患者的机械通气时间长于对照组（5 +/- 0.8 vs 3 +/- 0.6天; P <或= 0.03）。
结论
术前总二氧化碳含量、肾功能、术中给予柠檬酸盐和术后钾水平与初次奥尔特后MA独立相关。
BACKGROUND
Metabolic alkalosis (MA) is common after orthotopic liver transplantation (OLT).
METHODS
The study was conducted to identify factors associated with MA after 285 OLTs. MA, defined as total carbon dioxide content of 30 mEq/L or greater, developed in 115 patients (40%) within the first 3 postoperative days.
RESULTS
By univariate analysis, patients with MA had a greater preoperative carbon dioxide content (24.4 +/- 3 versus 22.9 +/- 2.9 mEq/L; P < 0.0001) and hematocrit (35% +/- 5% versus 33% +/- 6%; P < 0.02), but lower creatinine (0.9 +/- 0.5 versus 1.2 +/- 1.2 mg/dL; P < 0.001) and blood urea nitrogen levels (15 +/- 12 versus 19 +/- 17 mg/dL; P < 0.001) compared with controls. Patients with MA were administered more citrate intraoperatively compared with controls (6.2 +/- 5.2 versus 4.5 +/- 3.6 mEq/kg of body weight; P < 0.02). Patients with MA had a lower postoperative potassium level (3.7 +/- 0.4 versus 4 +/- 0.5 mEq/L; P < 0.0001) and cumulative fluid balance (-0.66 +/- 1.87 versus +0.003 +/- 3.9 L; P < 0.007) compared with controls. By multivariate analysis, preoperative carbon dioxide content (odds ratio, 1.19; 95% confidence interval [CI], 1.08 to 1.31 per mEq/L), creatinine level (odds ratio, 0.61; 95% CI, 0.39 to 0.96 per mg/dL), intraoperative administered citrate (odds ratio, 3.35; 95% CI, 1.71 to 6.53 per 10 mEq/kg body weight), and postoperative potassium level (odds ratio, 0.32; 95% CI, 0.18 to 0.57 per mEq/L) were independently associated with MA. MA was not associated with increased hospital mortality (7.8% versus 8.2%, MA versus controls). However, patients with MA spent more time on mechanical ventilation than controls (5 +/- 0.8 versus 3 +/- 0.6 days; P < or = 0.03).
CONCLUSION
Preoperative total carbon dioxide content, renal function, intraoperative administered citrate, and postoperative potassium level are independently associated with MA after primary OLT.
影响因子：
15.9
作者：
CAPASSO, G;JAEGER, P;MALNIC, G
通讯作者：
MALNIC, G
影响因子：
9.6
作者：
KNAUS, WA;WAGNER, DP;HARRELL, FE
通讯作者：
HARRELL, FE