Liver Transplantation Clinical Trial
Official title:
Record and Analyze the Data of Patient Undergoing Anesthesia for Liver Transplantation From Patient Monitoring Instruments
To record the intra-operative digital data from the standard monitoring instruments containing cardiovascular system information, and from depth-of-anesthesia monitoring modules (Bispectral index, Entropy module, Surgical Plethysmography Index) containing neurological system information captured in the patient monitor, as well as the physiological data regarding anesthetic dosage, respiratory gas analysis and the standard monitoring requirement of anesthesia. All above data comes from patients undergoing liver transplantation surgery for medical reason. The investigators also record the precise time points of detail surgical stages during the surgery . Clinical data collected from these monitoring instrument will be used to gain more understanding of the complex interaction between anesthetic effect, surgical procedure, autonomic response and drug modeling. The goal is to obtain the clinical value of various features extracted from physiological data, in particular the waveform data from cardiovascular system.
Liver transplantation surgery brings huge influences on the human body of the recipient
intra-operatively. Anesthesiologists facing challenges from hemodynamic function,
neurological function, coagulation function use monitoring instruments as a guide to make
timely anesthetic judgement. As good as those well designed monitoring instruments displaying
vital information, the investigators would like to explore any possible hidden data features
which is not perceivable with naked eye.
In this prospective observational study, the investigators will enroll 40 patients undergoing
liver transplantation surgery for medical reason. Anesthetic management and surgery will be
performed as usual clinical practice.
The investigators will record the digital data exported from standard monitoring instruments,
including cardiovascular system information (electrocardiography, photo-plethysmography ,
blood pressure, cardiac output, and any additional monitoring items clinically required),
parameters derived from pulse contour analysis (cardiac output, stroke volume, stroke volume
variation... etc.), neurological system information (Bispectral index, Entropy, Surgical
Plethysmography Index, cerebral oximeter ) and the respiratory gas monitoring (gas analyzer,
respiratory waveform). All above data are provided by monitoring instruments routinely used
for liver transplantation, including CARESCAPE Monitor B850 (GE Healthcare) FloTrac system
(Edwards Lifesciences).
The surgical steps will be noted with precise time stamps to establish temporal
relationships. Registered events including anesthetic induction, intubation, disinfection,
dissection stage, anhepatic stage , inferior vena cava clamping, reperfusion, neohepatic
stage and other important surgical steps. The recording is ended before the end of monitoring
in the operating room. All physiological data and demographic data will be stored in digital
media after being de-linked from personal identification.
Data analysis and Statistics will be particularly performed to explore the temporal effect
and relationship. Methods including signal processing, modeling, classification and
non-parametric spectral estimation will be used.
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