ArticleBMC anesthesiology2022
Intraoperative measurement of the respiratory exchange ratio predicts postoperative complications after liver transplantation.
Article in BMC anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 2 citations in OpenAlex.
- Preoperative hepatic encephalopathy predicts early postoperative complications after orthotopic liver transplantation: a retrospective cohort study.Clinics (Sao Paulo, Brazil) · 2026Article
- Intraoperative respiratory exchange ratio to predict complications after cardiopulmonary bypass surgery: a retrospective cohort study.Journal of clinical monitoring and computing · 2026Article
- Association between intraoperative hypothermia and total hospitalization cost after liver transplantation: a retrospective cohort study.Perioperative medicine (London, England) · 2026Article
- Oxygen metabolism after cardiac arrest: Patterns and associations with survival.Resuscitation plus · 2024Article
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Authors and funding
23 authors at 7 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring surgery, any mismatch between oxygen delivery (DO
methodsThis retrospective study included consecutive adult patients who underwent liver transplantation for end stage liver disease from June 27th, 2020, to September 5th, 2021. Patients with acute liver failure were excluded. All patients were routinely equipped with a pulmonary artery catheter. The primary analysis was a receiver operating characteristic (ROC) curve constructed to investigate the discriminative ability of the mean RER measured during surgery to predict postoperative complications. RER was calculated at five standardized time points during the surgery, at the same time as measurement of blood lactate levels and arterial and mixed venous blood gases, which were compared as a secondary analysis.
resultsOf the 115 patients included, 57 developed at least one postoperative complication. The mean RER (median [25-75] percentiles) during surgery was significantly higher in patients with complications than in those without (1.04[0.96-1.12] vs 0.88[0.84-0.94]; p < 0.001). The area under the ROC curve was 0.87 (95%CI: 0.80-0.93; p < 0.001) with a RER value (Youden index) of 0.92 giving a sensitivity of 91% and a specificity of 74% for predicting the occurrence of postoperative complications. The RER outperformed all other measured variables assessing the DO
conclusionDuring liver transplantation, the RER can reliably predict postoperative complications. Implementing this measure intraoperatively may provide a warning for physicians of impending complications and justify more aggressive optimization of oxygen delivery. Further studies are required to determine whether correcting the RER is feasible and could reduce the incidence of complications.
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