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Very early tracheal extubation without predetermined criteria in a liver transplant recipient population. (Articolo in rivista)

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Very early tracheal extubation without predetermined criteria in a liver transplant recipient population. (Articolo in rivista) (literal)

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Biancofiore G 1) , Romanelli AM 2) , Bindi ML 1), Consani G 1), Boldrini A 1), Battistini M 1), Filipponi F 1), Mosca F 1), Vagelli A. 1) (2001)
Very early tracheal extubation without predetermined criteria in a liver transplant recipient population.
in Liver transplantation (Print)
(literal)

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Biancofiore G 1) , Romanelli AM 2) , Bindi ML 1), Consani G 1), Boldrini A 1), Battistini M 1), Filipponi F 1), Mosca F 1), Vagelli A. 1) (literal)

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La rivista Liver Transpl. ha un Impact Factor = 3.030 . Nel triennio 2001-2003 sono stati pubblicati altri risultati : Antifungal prophylaxis in liver transplant recipients: a randomized placebo-controlled study. Transpl Int. 2002 Jul;15(7):341-7. Intra-abdominal pressure monitoring in liver transplant recipients: a prospective study. Intensive Care Med. 2003 Jan;29(1):30-6. (literal)

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Descrizione del prodotto: Procedure statistiche applicate ad indagini epidemiologiche in campo clinico volte alla messa a punto di standards metodologici per la cura ed il trattamento di pazienti sottoposti a trapianto di fegato (literal)

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1) Department No. 1 of Anaesthesia and Intensive Care, Postsurgical and Transplant Intensive Care Unit, Azienda Ospedaliera Pisana, Ospedale di Cisanello, Pisa, Italy 2) Istituto di Fisiologia Clinica del CNR, Pisa, Italy (literal)

Titolo

Very early tracheal extubation without predetermined criteria in a liver transplant recipient population. (literal)

Abstract

This study of all patients undergoing orthotopic liver transplantation (OLT) at our center between January 1997 and December 1999 evaluated the feasibility and safety of very early tracheal extubation without previous selection. Anesthetic management was the same in all cases, and tracheal extubation was performed on the basis of standardized criteria routinely adopted in operating rooms throughout the world, i.e., no residual curarization or anesthetic action, ability to swallow efficiently, and stable hemodynamics. One hundred sixty-nine patients underwent 181 OLTs during the study period. Tracheal extubation was performed within 3 hours of surgery in 115 cases, 8 hours in 19 cases, and 8 to 24 hours in 10 cases. In 36 cases, artificial ventilation was required for more than 24 hours or weaning was not possible. One patient died of primary graft nonfunction within 24 hours and was excluded from the analysis. The feasibility of early extubation was influenced by the amount of intraoperative transfused blood; efficacy of kidney, cardiac, and pulmonary function; and presence of encephalopathy (P <.001). No correlation was found with age or pre-OLT severity of hepatic disease, and the postoperative period was not compromised by early weaning. Very early extubation was feasible and safe in a large number of unselected transplant recipients, thus suggesting that the definition of early tracheal extubation should be changed from 8 to 3 hours after surgery. (literal)

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