Splanchnic circulation is maintained during passive hyperventilation in orthotopic liver recipients

Background: Mechanical hyperventilation is an established treatment to redu ce brain edema and intracranial pressure in patients with encephalopathia c aused by acute liver failure. Hyperventilation and ensuing hypocarbia may a lso affect central and systemic circulation and thereby influence graft per formance 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 hu mans 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 hem odynamics as well as indices of splanchnic oxygenation and indocyanine gree n kinetics remained statistically unchanged. Conclusion: We did not observe any statistically significant circulatory ef fects or changes in indocyanine green kinetics in Liver transplant recipien ts in the immediate OLT postoperative period caused by short-term mechanica l hyperventilation.