Splanchnic circulation is maintained during passive hyperventilation in orthotopic liver recipients

Background: Mechanical hyperventilation is an established treatment to reduce brain edema and intracranial pressure in patients with encephalopathia caused by acute liver failure. Hyperventilation and ensuing hypocarbia may also affect central and systemic circulation and thereby influence graft performance in patients following orthotopic liver transplantation (OLT). Methods: We measured the effects of normocapnia and hypocapnia on systemic hemodynamics, gastric tonometry, as a marker of splanchnic oxygenation, and the indocyanine green kinetic, as a global marker of graft function, in humans post OLT. Results: Hyperventilation was performed to a p(a)CO(2) of 4.2+/-0.4 kPa (31+/-3.4 mm Hg) for about 1 h in 14 liver transplant recipients. Systemic hemodynamics as well as indices of splanchnic oxygenation and indocyanine green kinetics remained statistically unchanged. Conclusion: We did not observe any statistically significant circulatory effects or changes in indocyanine green kinetics in Liver transplant recipients in the immediate OLT postoperative period caused by short-term mechanical hyperventilation.