Association of different central venous pressure levels with outcome of living-donor liver transplantation in children under 12 years
作者机构：Department of AnesthesiologyShanghai Jiaotong University School of Medicine Affiliated Renji HospitalNo.160 Pujian RoadPudong New DistrictShanghai200127China Nursing DepartmentShanghai Jiaotong University School of Medicine Affiliated Renji HospitalNo.160 Pujian RoadShanghaiChina
出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)
年 卷 期：2023年第19卷第2期
页 面：170-179页
核心收录：
学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学]
基 金：National Natural Science Foundation of China(Grant number 81771133,U21A20357,81970995) Foundation of National Health Commission of the People’s Republic of China(Grant number 2020JP003) Foundation of Plan on Technology and Innovation of Shanghai(Grant number 21015801500).
主 题：Central venous pressure General anesthesia Overall survival rate Pediatric living-donor liver transplantation Prognosis
摘 要：Background Pediatric liver transplantation is an important modality for treating biliary atresia.The overall survival(OS)rate of pediatric liver transplantation has significantly improved compared with that of 20 years ago,but it is still unsatisfactory.The anesthesia strategy of maintaining low central venous pressure(CVP)has shown a positive effect on prognosis in adult liver transplantation.However,this relationship remains unclear in pediatric liver transplantation.Thus,this study was conducted to review the data of pediatric living-donor liver transplantation to analyze the associations of different CVP levels with the prognosis of recipients.Methods This was a retrospective study and the patients were divided into two groups according to CVP levels after abdominal closure:low CVP(LCVP)(≤10 cmH2O,n=470)and high CVP(HCVP)(10 cmH2O,n=242).The primary outcome measured in the study was the overall survival rate.The secondary outcomes included the duration of mechanical ventilation in the intensive care unit(ICU),length of stay in the ICU,and postoperative stay in the hospital.Patient demographic and perioperative data were collected and compared between the two groups.Kaplan-Meier curves were constructed to determine the associations of different CVP levels with the survival rate.Results In the study,712 patients,including 470 in the LCVP group and 242 in the HCVP group,were enrolled.After propensity score matching,212 pairs remained in the group.The LCVP group showed a higher overall survival rate than the HCVP group in the Kaplan-Meier curves and multivariate Cox regression analyses(P=0.018),and the HCVP group had a hazard ratio of 2.445(95%confidence interval,1.163–5.140).Conclusion This study confirmed that a low-CVP level at the end of surgery is associated with improved overall survival and a shorter length of hospital stay.
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