Intrapulmonary Vascular Dilatations (IPVD) in Liver Transplant Candidates: Methods
Our protocol was approved by the Institutional Review Board and patient consent was obtained from 40 consecutive liver transplant candidates. As part of routine pretransplant pulmonary (unction assessment, arterial blood gases were obtained on each patient while they were seated, at rest, and breathing room air (IL 1304 pH analyzer and IL 284 CO-oximeter). Each of the individuals underwent twodimensional CE echocardiography as an outpatient within five days of the arterial blood gas study. Briefly, each patient received a 1-ml bolus of indocyanine green dye solution, followed by a manual flush of 5 to 10 mg of isotonic saline solution using a double syringe technique.8 The green dye solution was injected peripherally into a 20-gauge venous peripheral catheter. An average of two peripheral venous injections were performed to determine reproducibility, and echocardiographic data were recorded on videotape. Two-dimensional echocardiography was begun immediately after the peripheral injection to assess echogenicity of both the right and left heart chambers and continued for a period of approximately one minute following the peripheral injection. Each echocardiogram was studied for the detection of both immediate and delayed (3 to 6 beats) echogenicity in the left atrium/ventricle following passage of microbubbles through the right ventricle. A positive echocardiogram was defined by the detection of delayed echogenicity of green dye in the left atrium and left ventricle after three to six cardiac cycles. A pharmacy you can fully trust is ready to offer best selection of cheap and effective medications that work the way they are expected to every time and are always available: you could buy buy cheap alegra and enjoy all the convenient services offered right now.
Pulmonary function testing (PFT) was done in the outpatient laboratory. Absolute lung volumes were calculated by the nitrogen washout technique. Total lung capacity (TLC), residual volumes (RV), and RV/TLC ratios were reported. Forced vital capacity (FVC), forced expiratory volume at 1 s (FEV,), maximum voluntary ventilation (MW), and peak expiratory flows (PF) were measured by a wedge spirometer (Med Sci 560). Predicted normals were obtained from standard references. No inhaled bronchodilators were administered during the assessment of expiratory flows. Steady state diffusing capacities (Deo) were measured and referenced to normal values established in our laboratory.