Evaluation of EV1000™/volumeView™ for Cardiac Output Monitoring in Liver Transplantation
Condition: Liver Disease
MeSH terms: Liver Diseases
Study type: Observational

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): EV1000™/volumeView™
Intervention type(s): Device
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        patients who are performed liver transplantation in Samsung medical center
      
Keywords: liver transplantation; cardiac output