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During orthotopic liver transplantation (OLT), respiratory system function may be severely impaired for several reasons including anaesthesia effects, hyperdynamic volume state with fluid overload and ischemia reperfusion injury. In particular, reperfusion syndrome is characterised by the release of several inflammatory mediators such as cytokines and oxygen free radicals which may contribute to alveolar endothelial barrier dysfunction. The object of this study is to investigate the respiratory system mechanics impairment in its partitioning between lung and chest wall.
We hypothesize that impairment of respiratory system mechanics (of both lung and chest wall) occurs after reperfusion phase of liver. This impairment is associated with the systemic inflammatory response following liver reperfusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients undergoing OLT | insertion of nasogastric tube for measurements of chest wall mechanics |
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| Measure | Description | Time Frame |
|---|---|---|
| Elastance of Respiratory System, Lung and Chest Wall | at 90 minutes after liver reperfusion | |
| Elastance of Respiratory System, Lung and Chest Wall | at 3 hours after liver reperfusion | |
| Elastance of Respiratory System, Lung and Chest Wall | at 24 hours after liver reperfusion |
| Measure | Description | Time Frame |
|---|---|---|
| Acute respiratory failure | 28 days | |
| Ventilator free days | 28 days | |
| ICU length of stay |
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Inclusion Criteria:
Exclusion Criteria:
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patients with end stage liver diseases undergoing to liver transplantation
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Vito Fanelli, MD, PhD | Contact | vito.fanelli@unito.it |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Azienda Ospedaliera Città della Salute e della Scienza di Torino | Recruiting | Turin | Turin | 10126 | Italy |
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| ID | Term |
|---|---|
| D001261 | Pulmonary Atelectasis |
| D010996 | Pleural Effusion |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D010995 | Pleural Diseases |
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Blood samples at four time points during OLT
| 28 days |
| hospital length of stay | 28 days |
| Inflammatory mediators in plasma samples | baseline, 90 minutes, 3 hours and 24 hours after reperfusion phase |
| Inflammatory mediators in urine samples | baseline, 90 minutes, 3 hours and 24 hours after reperfusion phase |