Analysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study
Abstract Background Early extubation after liver transplantation is safe and accelerates patient recovery. Patients with end-stage liver disease undergo sarcopenic changes, and sarcopenia is associated with postoperative morbidity and mortality. We investigated the impact of core muscle mass on the...
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-019-0781-z |
| _version_ | 1818334850179923968 |
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| author | Min Suk Chae Jong-Woan Kim Joon-Yong Jung Ho Joong Choi Hyun Sik Chung Chul Soo Park Jong Ho Choi Sang Hyun Hong |
| author_facet | Min Suk Chae Jong-Woan Kim Joon-Yong Jung Ho Joong Choi Hyun Sik Chung Chul Soo Park Jong Ho Choi Sang Hyun Hong |
| author_sort | Min Suk Chae |
| collection | DOAJ |
| description | Abstract Background Early extubation after liver transplantation is safe and accelerates patient recovery. Patients with end-stage liver disease undergo sarcopenic changes, and sarcopenia is associated with postoperative morbidity and mortality. We investigated the impact of core muscle mass on the feasibility of immediate extubation in the operating room (OR) after living donor liver transplantation (LDLT). Methods A total of 295 male adult LDLT patients were retrospectively reviewed between January 2011 and December 2017. In total, 40 patients were excluded due to emergency surgery or severe encephalopathy. A total of 255 male LDLT patients were analyzed in this study. According to the OR extubation criteria, the study population was classified into immediate and conventional extubation groups (39.6 vs. 60.4%). Psoas muscle area was estimated using abdominal computed tomography and normalized by height squared (psoas muscle index [PMI]). Results There were no significant differences in OR extubation rates among the five attending transplant anesthesiologists. The preoperative PMI correlated with respiratory performance. The preoperative PMI was higher in the immediate extubation group than in the conventional extubation group. Potentially significant perioperative factors in the univariate analysis were entered into a multivariate analysis, in which preoperative PMI and intraoperative factors (i.e., continuous renal replacement therapy, significant post-reperfusion syndrome, and fresh frozen plasma transfusion) were associated with OR extubation. The duration of ventilator support and length of intensive care unit stay were shorter in the immediate extubation group than in the conventional extubation group, and the incidence of pneumonia and early allograft dysfunction were also lower in the immediate extubation group. Conclusions Our study could improve the accuracy of predictions concerning immediate post-transplant extubation in the OR by introducing preoperative PMI into predictive models for patients who underwent elective LDLT. |
| first_indexed | 2024-12-13T14:14:05Z |
| format | Article |
| id | doaj.art-54168f9774c744878507c976830a994d |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-13T14:14:05Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-54168f9774c744878507c976830a994d2022-12-21T23:42:22ZengBMCBMC Anesthesiology1471-22532019-06-0119111010.1186/s12871-019-0781-zAnalysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort studyMin Suk Chae0Jong-Woan Kim1Joon-Yong Jung2Ho Joong Choi3Hyun Sik Chung4Chul Soo Park5Jong Ho Choi6Sang Hyun Hong7Department of Anesthesiology and Pain medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Anesthesiology and Pain medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Anesthesiology and Pain medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Anesthesiology and Pain medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Anesthesiology and Pain medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Anesthesiology and Pain medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaAbstract Background Early extubation after liver transplantation is safe and accelerates patient recovery. Patients with end-stage liver disease undergo sarcopenic changes, and sarcopenia is associated with postoperative morbidity and mortality. We investigated the impact of core muscle mass on the feasibility of immediate extubation in the operating room (OR) after living donor liver transplantation (LDLT). Methods A total of 295 male adult LDLT patients were retrospectively reviewed between January 2011 and December 2017. In total, 40 patients were excluded due to emergency surgery or severe encephalopathy. A total of 255 male LDLT patients were analyzed in this study. According to the OR extubation criteria, the study population was classified into immediate and conventional extubation groups (39.6 vs. 60.4%). Psoas muscle area was estimated using abdominal computed tomography and normalized by height squared (psoas muscle index [PMI]). Results There were no significant differences in OR extubation rates among the five attending transplant anesthesiologists. The preoperative PMI correlated with respiratory performance. The preoperative PMI was higher in the immediate extubation group than in the conventional extubation group. Potentially significant perioperative factors in the univariate analysis were entered into a multivariate analysis, in which preoperative PMI and intraoperative factors (i.e., continuous renal replacement therapy, significant post-reperfusion syndrome, and fresh frozen plasma transfusion) were associated with OR extubation. The duration of ventilator support and length of intensive care unit stay were shorter in the immediate extubation group than in the conventional extubation group, and the incidence of pneumonia and early allograft dysfunction were also lower in the immediate extubation group. Conclusions Our study could improve the accuracy of predictions concerning immediate post-transplant extubation in the OR by introducing preoperative PMI into predictive models for patients who underwent elective LDLT.http://link.springer.com/article/10.1186/s12871-019-0781-zPsoas musclesLiver transplantationAirway extubationOperating rooms |
| spellingShingle | Min Suk Chae Jong-Woan Kim Joon-Yong Jung Ho Joong Choi Hyun Sik Chung Chul Soo Park Jong Ho Choi Sang Hyun Hong Analysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study BMC Anesthesiology Psoas muscles Liver transplantation Airway extubation Operating rooms |
| title | Analysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study |
| title_full | Analysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study |
| title_fullStr | Analysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study |
| title_full_unstemmed | Analysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study |
| title_short | Analysis of pre- and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation: a retrospective observational cohort study |
| title_sort | analysis of pre and intraoperative clinical factors for successful operating room extubation after living donor liver transplantation a retrospective observational cohort study |
| topic | Psoas muscles Liver transplantation Airway extubation Operating rooms |
| url | http://link.springer.com/article/10.1186/s12871-019-0781-z |
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