Sympathetic withdrawal is associated with hypotension after hepatic reperfusion
Objective: Post-reperfusion syndrome (PRS), severe hypotension after graft reperfusion during liver transplantation, is an adverse clinical event associated with poorer patient outcomes. The purpose of this study was to determine whether alterations in autonomic control in liver transplant recipient...
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| Format: | Article |
| Language: | English |
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Springer-Verlag
2016
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| Online Access: | http://hdl.handle.net/1721.1/104629 https://orcid.org/0000-0002-4058-3832 |
| _version_ | 1826198869776531456 |
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| author | Hwang, Gyu-Sam Kim, Young Kug Lee, Kichang |
| author2 | Massachusetts Institute of Technology. Institute for Medical Engineering & Science |
| author_facet | Massachusetts Institute of Technology. Institute for Medical Engineering & Science Hwang, Gyu-Sam Kim, Young Kug Lee, Kichang |
| author_sort | Hwang, Gyu-Sam |
| collection | MIT |
| description | Objective: Post-reperfusion syndrome (PRS), severe hypotension after graft reperfusion during liver transplantation, is an adverse clinical event associated with poorer patient outcomes. The purpose of this study was to determine whether alterations in autonomic control in liver transplant recipients prior to graft reperfusion are associated with the subsequent development of PRS.
Methods: Heart rate variability (HRV), systolic arterial blood pressure (SBP) variability, and baroreflex sensitivity of 218 liver transplant recipients were evaluated using 5 min of ECG and arterial blood pressure signals 10 min before graft reperfusion along with other clinical parameters. Logistic regression analyses were performed to assess predictors of PRS occurrence.
Results: Seventy-seven patients (35 %) developed PRS while 141 did not. There were significant differences in SBP (110 ± 16 vs. 119 ± 16 mmHg, P < 0.001) and the ratio of low frequency power to high frequency power (LF/HF) of HRV (1.0 ± 1.4 vs. 2.1 ± 3.7, P = 0.003) between the PRS group and No-PRS group. In multivariate logistic regression analysis, predictors were LF/HF (odds ratio 0.817, P = 0.028) and SBP (odds ratio 0.966, P < 0.001).
Interpretation: Low LF/HF and SBP measured before hepatic graft reperfusion were significantly correlated with subsequent PRS occurrence, suggesting that sympathovagal imbalance and depressed SBP may be key factors predisposing to reperfusion-related severe hypotension in liver transplant recipients. |
| first_indexed | 2024-09-23T11:11:16Z |
| format | Article |
| id | mit-1721.1/104629 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T11:11:16Z |
| publishDate | 2016 |
| publisher | Springer-Verlag |
| record_format | dspace |
| spelling | mit-1721.1/1046292022-10-01T01:54:41Z Sympathetic withdrawal is associated with hypotension after hepatic reperfusion Hwang, Gyu-Sam Kim, Young Kug Lee, Kichang Massachusetts Institute of Technology. Institute for Medical Engineering & Science Harvard University--MIT Division of Health Sciences and Technology Kim, Young Kug Lee, Kichang Objective: Post-reperfusion syndrome (PRS), severe hypotension after graft reperfusion during liver transplantation, is an adverse clinical event associated with poorer patient outcomes. The purpose of this study was to determine whether alterations in autonomic control in liver transplant recipients prior to graft reperfusion are associated with the subsequent development of PRS. Methods: Heart rate variability (HRV), systolic arterial blood pressure (SBP) variability, and baroreflex sensitivity of 218 liver transplant recipients were evaluated using 5 min of ECG and arterial blood pressure signals 10 min before graft reperfusion along with other clinical parameters. Logistic regression analyses were performed to assess predictors of PRS occurrence. Results: Seventy-seven patients (35 %) developed PRS while 141 did not. There were significant differences in SBP (110 ± 16 vs. 119 ± 16 mmHg, P < 0.001) and the ratio of low frequency power to high frequency power (LF/HF) of HRV (1.0 ± 1.4 vs. 2.1 ± 3.7, P = 0.003) between the PRS group and No-PRS group. In multivariate logistic regression analysis, predictors were LF/HF (odds ratio 0.817, P = 0.028) and SBP (odds ratio 0.966, P < 0.001). Interpretation: Low LF/HF and SBP measured before hepatic graft reperfusion were significantly correlated with subsequent PRS occurrence, suggesting that sympathovagal imbalance and depressed SBP may be key factors predisposing to reperfusion-related severe hypotension in liver transplant recipients. 2016-09-30T21:34:17Z 2016-09-30T21:34:17Z 2013-03 2012-10 2016-08-18T15:36:30Z Article http://purl.org/eprint/type/JournalArticle 0959-9851 1619-1560 http://hdl.handle.net/1721.1/104629 Kim, Young-Kug et al. “Sympathetic Withdrawal Is Associated with Hypotension after Hepatic Reperfusion.” Clinical Autonomic Research 23.3 (2013): 123–131. https://orcid.org/0000-0002-4058-3832 en http://dx.doi.org/10.1007/s10286-013-0191-0 Clinical Autonomic Research Creative Commons Attribution-NonCommercial-Share Alike http://creativecommons.org/license/by-nc-sa/4.0/ Springer-Verlag Berlin Heidelberg application/pdf Springer-Verlag Springer-Verlag |
| spellingShingle | Hwang, Gyu-Sam Kim, Young Kug Lee, Kichang Sympathetic withdrawal is associated with hypotension after hepatic reperfusion |
| title | Sympathetic withdrawal is associated with hypotension after hepatic reperfusion |
| title_full | Sympathetic withdrawal is associated with hypotension after hepatic reperfusion |
| title_fullStr | Sympathetic withdrawal is associated with hypotension after hepatic reperfusion |
| title_full_unstemmed | Sympathetic withdrawal is associated with hypotension after hepatic reperfusion |
| title_short | Sympathetic withdrawal is associated with hypotension after hepatic reperfusion |
| title_sort | sympathetic withdrawal is associated with hypotension after hepatic reperfusion |
| url | http://hdl.handle.net/1721.1/104629 https://orcid.org/0000-0002-4058-3832 |
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