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A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation

BACKGROUND AND AIMS: Intraoperative fluid management is important in renal transplant recipients with end-stage renal disease. Conventionally, central venous pressure (CVP) has been used to guide perioperative fluid administration but with high incidence of poor graft outcome. There is a requirement...

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Autores principales: Goyal, Vipin Kumar, Gupta, Priyamvada, Baj, Birbal, Garg, Vishnu Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944348/
https://www.ncbi.nlm.nih.gov/pubmed/35340962
http://dx.doi.org/10.4103/joacp.JOACP_23_20
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author Goyal, Vipin Kumar
Gupta, Priyamvada
Baj, Birbal
Garg, Vishnu Kumar
author_facet Goyal, Vipin Kumar
Gupta, Priyamvada
Baj, Birbal
Garg, Vishnu Kumar
author_sort Goyal, Vipin Kumar
collection PubMed
description BACKGROUND AND AIMS: Intraoperative fluid management is important in renal transplant recipients with end-stage renal disease. Conventionally, central venous pressure (CVP) has been used to guide perioperative fluid administration but with high incidence of poor graft outcome. There is a requirement of reliable parameter to guide the fluid therapy in these patients so as to minimize the perioperative complications and improve the outcome. Hence, this study was conducted. MATERIAL AND METHODS: This prospective study included 75 patients of chronic kidney disease undergoing renal transplantation. Patients were divided into two groups. Group A (control group): Intraoperative fluids were guided by CVP; Group B: Intraoperative fluids were guided by pulse pressure variation (PPV). Primary outcome measure of this study was incidence of delayed graft functioning, i.e., need of hemodialysis within 7 days of renal transplant. Secondary outcome measures were incidence of perioperative hypotension, post-transplant pulmonary edema, tissue edema, and lactic acidosis. RESULTS: Total amount of fluid before reperfusion was significantly greater in the control group (P = 0.005). However, the total amount of fluid required at the end of surgery was comparable. Delayed graft functioning was seen only in CVP group, although it was not statistically significant. The postoperative tissue edema was more in CVP group (P = 0.03). The postoperative nausea and vomiting, pulmonary edema, and mechanical ventilation were more in CVP group but not statistically significant. Increase in lactate value was more in CVP group. CONCLUSION: Perioperative fluid guidance by PPV is better than central venous pressure in renal transplant patients.
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spelling pubmed-89443482022-03-25 A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation Goyal, Vipin Kumar Gupta, Priyamvada Baj, Birbal Garg, Vishnu Kumar J Anaesthesiol Clin Pharmacol Original Article BACKGROUND AND AIMS: Intraoperative fluid management is important in renal transplant recipients with end-stage renal disease. Conventionally, central venous pressure (CVP) has been used to guide perioperative fluid administration but with high incidence of poor graft outcome. There is a requirement of reliable parameter to guide the fluid therapy in these patients so as to minimize the perioperative complications and improve the outcome. Hence, this study was conducted. MATERIAL AND METHODS: This prospective study included 75 patients of chronic kidney disease undergoing renal transplantation. Patients were divided into two groups. Group A (control group): Intraoperative fluids were guided by CVP; Group B: Intraoperative fluids were guided by pulse pressure variation (PPV). Primary outcome measure of this study was incidence of delayed graft functioning, i.e., need of hemodialysis within 7 days of renal transplant. Secondary outcome measures were incidence of perioperative hypotension, post-transplant pulmonary edema, tissue edema, and lactic acidosis. RESULTS: Total amount of fluid before reperfusion was significantly greater in the control group (P = 0.005). However, the total amount of fluid required at the end of surgery was comparable. Delayed graft functioning was seen only in CVP group, although it was not statistically significant. The postoperative tissue edema was more in CVP group (P = 0.03). The postoperative nausea and vomiting, pulmonary edema, and mechanical ventilation were more in CVP group but not statistically significant. Increase in lactate value was more in CVP group. CONCLUSION: Perioperative fluid guidance by PPV is better than central venous pressure in renal transplant patients. Wolters Kluwer - Medknow 2021 2022-01-06 /pmc/articles/PMC8944348/ /pubmed/35340962 http://dx.doi.org/10.4103/joacp.JOACP_23_20 Text en Copyright: © 2022 Journal of Anaesthesiology Clinical Pharmacology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Goyal, Vipin Kumar
Gupta, Priyamvada
Baj, Birbal
Garg, Vishnu Kumar
A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
title A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
title_full A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
title_fullStr A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
title_full_unstemmed A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
title_short A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
title_sort randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944348/
https://www.ncbi.nlm.nih.gov/pubmed/35340962
http://dx.doi.org/10.4103/joacp.JOACP_23_20
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