In Response

Abstract

Liver transplant patients with and without pulmonary hypertension were enrolled in an observational study and told that while management in both groups was similar, the subjects were unaware of the degree of pulmonary hypertension.1 We believed that this would eliminate any impact of unnecessary preoperative stress on the basal values measured postinduction. Meanwhile, an anesthetist blinded to the preoperative pulmonary artery pressures recorded the intraoperative parameters and gave fluids in response to the readings. We postulated that awareness of the existence of portopulmonary hypertension may trigger the anesthetist to discard or repeat readings to attain a given value or delay fluid administration if the patient was known to have portopulmonary hypertension. This was done to eliminate any possible bias without adding risk to the patient. Amr M. Yassen, MD Waleed R. Elsarraf, MD Mohamed M. Elshobari, MD Tarek Salah, MD Ahmed M. Sultan, MD Gastroenterology Surgical Center Mansoura University Mansoura, Egypt [email protected] Mohamed Elsadany, MD Faculty of Medicine Mansoura University Mansoura, Egypt