Liver Disease Clinical Trial
Official title:
Evaluation of a New Calibrated Pulse Wave Analysis Method(EV1000™/volumeView™) for Cardiac Output Monitoring in Adult Liver Transplantation
The investigators are trying to evaluate the agreement of cardiac output measurements taken using the specific thermistor-tipped arterial catheter ( the VolumeView ™ catheter) and the EV1000 ™ monitoring platform ( Edward lifesciences, Irvine, CA, USA) with measurements taken using continuous pulmonary artery thermodilution cardiac output monitoring during orthotopic liver transplantation.
In cirrhotic patient undergoing liver transplantation, there are an altered patterm of
circulation, which is characterized by increased cardiac output, decreased peripheral
vascular resistance, and reduced ventricular response to physiological, pharmacological, and
surgical stress. Large blood loss and clamping/declamping of the inferior vena cava and
portal vein during liver transplantation surgery can affect intravascular volume status,
which in turn can lead to hemodynamic instability. Therefore, reliable cardiac output
monitoring is particularly useful in the cirrhotic patient undergoing liver transplant.
Pulmonary artery thermodilution has been used as a standard method for cardiac output
assessment for many years. Pulmonary artery catheter can cause rare but serious
complications. And it has some limitations for continuously monitoring cardiac output during
rapid hemodynamic changes.
Recently, several minimally invasive CO monitors have been developed. The pulse contour
technique continuously estimates CO through mathematical analysis of the waveform of
arterial pressure. However, previous studies evaluating the reliability of the pulse contour
techniques indicated conflicting results in cirrhotic patients during liver transplantation.
Most of studies were performed by analyzing from radial artery pressure waveform. Because of
rapid changing of intravascular volume, using inotropics, the monitoring of femoral artery
pressure has been recommended during liver transplantation.
A new pulse wave analysis system has developed and introduced into clinical practice that
consists of a specific thermistor -tipped femoral arterial catheter ( the VolumeView™
catheter) and the EV1000™ monitoring platform ( Edward lifesciences, Irvine, CA, USA). To
continuously assess CO based on the femoral arterial pressure curve signal and it uses
transpulmonary thermodilution for calibration. We are trying to evaluate the agreement of
cardiac output measurements taken using EV1000™ / VolumeView™ with measurements taken using
continuous pulmonary artery thermodilution cardiac output monitoring during orthotopic liver
transplantation.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label
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