RESPIRATORY COMPLIANCE DURING ORTHOTOPIC LIVER-TRANSPLANTATION

After liver transplantation, respiratory complications are frequent. T he purpose of this study was to assess if intraoperative monitoring of respiratory compliance is of clinical value in predicting such compli cations. Respiratory compliance was continuously monitored with a side -stream respiratory gas flow and pressure sensor (Datex, Helsinki, Fin land) at the endotracheal tube in 18 adult patients undergoing orthoto pic liver transplantation without veno-venous bypass. Respiratory comp liance decreased along with blood volume expansion under anaesthesia b efore the start of surgery (P<0.05). Compliance improved as ascites wa s removed at the beginning of laparotomy (P<0.001). The highest compli ance values were seen during liver surgery. In the patients without as cites preoperatively, compliance was lower at the end of surgery than at anaesthesia induction (P<0.001). In the patients with ascites, comp liance at the end of surgery was equally low as at anaesthesia inducti on. Compliance at the end of surgery was lower in the patients with bi lateral than in those with right-sided or no pleural effusions in the postoperative chest-X-rays (P<0.001). In conclusion, intraoperative mo nitoring of respiratory compliance is one useful method for clinical u se in predicting postoperative bilateral pleural effusions.