An intraoperative fluid therapy fuzzy logic control system for renal transplantation

Yardimci A., Hadimioglu N.

EUROPEAN JOURNAL OF CONTROL, cilt.11, sa.6, ss.572-585, 2005 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 11 Sayı: 6
  • Basım Tarihi: 2005
  • Doi Numarası: 10.3166/ejc.11.572-585
  • Dergi Adı: EUROPEAN JOURNAL OF CONTROL
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.572-585
  • Anahtar Kelimeler: anesthesia, fluid therapy, fuzzy logic control, intravascular volume management, renal transplantation, transplantation, CORONARY-ARTERY-DISEASE, CLOSED-LOOP CONTROL, DIABETIC-PATIENTS, ANESTHESIA, KIDNEY, COMPLICATIONS, DEPTH, RESUSCITATION, IMPROVES
  • Akdeniz Üniversitesi Adresli: Evet

Özet

The number of kidney transplants has increased sharply in recent years mainly due to addition of pathologic cases, (e.g. patient with type diabetes II advanced cardiomyopathy, various forms of vasculitis, sickle cell disease and morbid obesity) which were considered as high risk group, to regular renal transplantation (RT) operations. However, it is still a fact that many patients undergoing RT operations have a higher chance of getting intraoperative complication than regular patient group. As a result, anesthesiologists load was increased significantly in RT operations. Maximal hydration during RT is of utmost importance. The most important intraoperative measure that improves the likelihood of immediate graft function is to maintain an adequate intravascular volume and ensure satisfactory perfusion of the transplanted kidney. Intravascular volume is a crucial factor in the maintenance of hemodynamic stability, tissue oxygenation and organ function. Crystalloid solutions are the first choice to correct fluid and electrolyte deficits in these patients. However, in case of major hypovolemia, particularly in situations of increased capillary permeability, colloid solutions are indicated to achieve sufficient tissue perfusion. Because of the fluid abnormalities usually found in patients with renal failure, the high incidence of cardiac disease and the importance of graft perfusion and early function, central venous pressure (CVP) monitoring is recommended. A CVP of 10-15 mm Hg has been recommended to maintain optimal intravascular
Abstract

The number of kidney transplants has increased sharply in recent years mainly due to addition of pathologic cases, (e.g. patient with type diabetes II advanced cardiomyopathy, various forms of vasculitis, sickle cell disease and morbid obesity) which were considered as high risk group, to regular renal transplantation (RT) operations. However, it is still a fact that many patients undergoing RT operations have a higher chance of getting intraoperative complication than regular patient group. As a result, anesthesiologists load was increased significantly in RT operations. Maximal hydration during RT is of utmost importance. The most important intraoperative measure that improves the likelihood of immediate graft function is to maintain an adequate intravascular volume and ensure satisfactory perfusion of the transplanted kidney. Intravascular volume is a crucial factor in the maintenance of hemodynamic stability, tissue oxygenation and organ function. Crystalloid solutions are the first choice to correct fluid and electrolyte deficits in these patients. However, in case of major hypovolemia, particularly in situations of increased capillary permeability, colloid solutions are indicated to achieve sufficient tissue perfusion. Because of the fluid abnormalities usually found in patients with renal failure, the high incidence of cardiac disease and the importance of graft perfusion and early function, central venous pressure (CVP) monitoring is recommended. A CVP of 10-15 mm Hg has been recommended to maintain optimal intravascular