Postoperative hyperbilirubinemia after implantation of left ventricular assist device is associated with poor postoperative liver perfusion

被引：12

作者：

Fujita Y. ^{[1
]}

Fujino Y. ^{[1
]}

Matsumiya G. ^{[2
]}

Sawa Y. ^{[2
]}

Mashimo T. ^{[1
,3
]}

Matsuda H. ^{[2
]}

Nishimura M. ^{[4
]}

机构：

[1] Intensive Care Unit, Osaka University Hospital, Suita, Osaka 565-0871

[2] Division of Cardiovascular Surgery, Department of Surgery, Osaka University Hospital, Osaka

[3] Department of Anesthesiology, Osaka University Medical School, Osaka

[4] Department of Emergency and Intensive Care Unit, Tokushima University, School of Medicine, Tokushima

来源：

Journal of Artificial Organs | 2005年 / 8卷 / 1期

关键词：

Cardiac index; End-stage cardiac failure; Hepatic perfusion; Hyperbilirubinemia; LVAD;

D O I：

10.1007/s10047-004-0276-6

中图分类号：

学科分类号：

摘要：

Hyperbilirubinemia, a common complication associated with left ventricular assist device (LVAD) implantation, is evidence of liver dysfunction and is often a life-threatening problem after the implantation procedure. In this study we evaluated the relationship between hemodynamics after LVAD implantation and postoperative hyperbilirubinemia. Twenty-four patients who received LVADs at Osaka University Hospital between January 1994 and June 2002 were retrospectively reviewed. Patients were grouped according to the implanted LVAD: Group A (n = 4) Novacor, group B (n = 7) HeartMate 1000IP, group C (n = 13) Toyobo pneumatic pulsatile pump. Hemodynamic data and laboratory data, including total bilirubin on postoperative days (PODs) 1, 3, 7, and 14, were collected and statistically analyzed. In group C, the cardiac index (CI) on POD 1 was significantly lower (P < 0.01) than that for groups A and B. On PODs 3 and 7, total bilirubin levels in group C increased significantly over the preoperative value (P < 0.05) and were significantly higher than those in group A on POD 3 and higher than those in groups A and B on POD 7 (P < 0.05). Regression analysis of CI on POD 1 correlated significantly with total bilirubin on POD 7, as expressed by the formula y = 5.13/(x - 1.7)0.719, where x is CI and y is total bilirubin (r 2 = 0.327, P < 0.05). Total bilirubin after LVAD implantation correlates with postoperative CI values. We suggest that it is essential to maintain the CI at the highest levels possible to avoid postoperative hyperbilirubinemia in LVAD patients. © The Japanese Society for Artificial Organs 2005.

引用

页码：28 / 33

页数：5

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