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Coagulation and haemodynamic monitoring 

Coagulation and haemodynamic monitoring
Chapter:
Coagulation and haemodynamic monitoring
Author(s):

Mark Hayman

and Andrew Watts

DOI:
10.1093/med/9780199651429.003.0037
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date: 17 August 2019

Monitoring of both physiological and pathophysiological states associated with end-stage liver disease during orthotopic liver transplantation (OLT) has evolved considerably since the advent of the operation. Major changes in the cardiovascular and coagulation systems occur during OLT. The goal of the anaesthesiologist is to maintain homeostasis and minimize the impact of these perturbations upon the patient. Laboratory coagulation (quantitative) monitoring is supplemented by point-of-care global haemostasis (qualitative) monitoring in the form of thromboelastography/thromboelastometry to provide information about patient coagulation status. Invasive haemodynamic monitoring has been used from the advent of OLT. More recently, transoesophageal echocardiography and other monitors of blood-volume status have been utilized. This chapter discusses the commonly used modes of coagulation and cardiovascular monitoring and touches briefly on the more recent developments in metabolic and cerebral monitoring during OLT.

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