الفهرس 
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Abstract
Objective: to study the perioperative effect of Dexmedetomidine on
indirect calorimetry in recipients of adult living donor liver
transplantation.
Background: dexmedetomidine is newly used in liver transplant.
Material and Methods: forty patients were assigned randomly to get
Dexmedetomidine (Dex) beginning at 0.5 μg/kg/h (0.2-0.7μg/kg/h) or
placebo (C) Anesthesia was guided by Enotropy (40-60) with Desflurane.
Indirect calorimetry parameters, arterial blood gasses, hemodynamics
were taken at base line, dissection, anhepatic, reperfusion and 3 hours
after end of operation. Trans esophageal Doppler was used for fluid
optimization. Results:. no significant difference was noticed in either
group regarding demographic data, and operative data ,
Dexmedetomidine affects oxygen consumption(Vo2) and carbon dioxide
production(Vco2) significantly at reperfusion and few hours post
reperfusion ;Mean±SD for VO2 (273.1±36.1/227.1±82),(252.4
±39/189.5±75) ml/min/m2and P=0.019,0.005 for control /DEX groups at
reperfusion and intensive care unit(I.C.U) respectively ,
VCO2(238.4±18/181.5±72), (210.5±27/159.0±63) ±78.77 ml/min/m2
:p =0.002,0.001 also for control /DEX respectively. Respiratory Quotient
(RQ) and Energy expenditure (EE) were significant in C versus DEX at
reperfusion and in intensive care ,for RQ in C/DEX
(0.79±0.08/0.73±0.08), (0.75±0.8/0.70±0.10)with p=0.014,0.001.
EE for C/DEX (1358.5±152.4/1231.5±84.9),
(1264.3±147.0/1068.1±122.9) and P=0.000,0.001 sequentially .Hemodynamics were insignificantly decreased in DEX versus C .DEX
decreased significantly the utilization of Desflurane in DEX/C
(179±59/221±5 p=0.016)ml, Dexmedetomidine also decreased
significantly Fentanyl (988±202/1241±390p=0.041) μg, and
insignificantly increased amounts of fluids needed and the inotropic
support. pH and Paco2,HCO3 were insignificantly affected in both
groups. except in reperfusion, where pH decreased significantly and
Paco2 increased significantly. The I.C.U. stay was comparable.
Conclusion: dexmedetomidine has a depressing effect on indirect
calorimetry especially in reperfusion.