A Randomized Trial of Exercise and Dietary Counseling After Liver Transplantation

Krasnoff, Joanne B.; Vintro, Andrea Q.; Ascher, Nancy L.; Bass, Nathan M.; Paul, Steven M.; Dodd, Marylin; Painter, Patricia

doi:10.1111/j.1600-6143.2006.01391.x

Cited by 149 publications

(148 citation statements)

References 34 publications

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“…Postoperatif pulmoner komplikasyonların azaltılmasında erken ekstübasyon, ekstübasyon sonrası solunum fizyoterapisi ve erken mobilizasyon, NİV uygulaması, yeterli postoperatif ağrı tedavisi, hipervoleminin önlenmesi, bronşiyal sekresyonların etkin temizlenmesi ve enfeksiyonların önlenmesi önemli yer tutar (12,83,84,91,103).…”

Section: Pulmoner Sorunlar Ve Solunumsal Yönetimunclassified

Critical Care Management after Adult Liver Transplantation

Akan¹

2017

tybdd

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1ÖZ Karaciğer transplantasyonu uygulanan hastaların yoğun bakım yönetimi çok yönlü bir izlemi ve multidisipliner bir yaklaşımı gerektirir. Günümüzde ideal bir yoğun bakım tedavisi için deneyimli bir ekibe ve gelişmiş yoğun bakım/hastane olanaklarına gereksinim vardır. Karaciğer transplantasyon olgularının postoperatif yoğun bakım yönetimi zaman içinde hızlı bir gelişme göstermiştir. Preoperatif optimizasyon, cerrahi teknik, intraoperatif anestezi yönetimi, organ prezervasyonu, yoğun bakım ve immünosüpresyon tedavilerindeki gelişmeler ile 1998'de %79 düzeyinde olan karaciğer transplantasyonu sonrası bir yıllık sağkalım 2008'de %90'a yükselmiştir. Karaciğer transplantasyonlu olguların yoğun bakım yönetiminde özellikle hızlı kardiyorespiratuvar stabilizasyon, ağır koagülopatinin düzeltilmesi, mekanik ventilasyondan erken ayırma, uygun sıvı-elektrolit tedavisi, böbrek fonksiyonlarının korunması, greft rejeksiyonun önlenmesi ve enfeksiyon profilaksisi/tedavisi büyük önem taşır. Erken postoperatif dönem çok hassas bir süreç olduğundan yakın monitörizasyon, kardiyorespiratuvar fonksiyonların stabilizasyonu, greft fonksiyonunun sık değerlendirilmesi, komplikasyonların erken tanınması ve ekstrahepatik organ yetersizliklerinin hızlı tedavisi mortalite/morbiditenin azaltılabilmesi için zorunludur. Anahtar Kelimeler: Karaciğer transplantasyonu, postoperatif dönem, yoğun bakım, karaciğer yetersizliği ABSTRACT Critical care management after liver transplantation requires a sophisticated monitoring and multi-disciplinary team work. An experienced team and advanced critical care/hospital facilities are necessary for an ideal critical care treatment today. Critical care management after liver transplantation has shown a rapid development since the introduction of liver transplantation. While one-year survival rate after liver transplantation was 79% in 1998, it raised to 90% in 2008 related to the improvements in preoperative optimization, surgical technique, anesthetic management, organ preservation, critial care and immunosuppressive treatment. Treatment of severe coagulopathy, prompt hemodynamic and respiratory stabilization, early weaning from mechanical ventilation, proper fluid-electrolyte therapy, prevention of graft rejection, protection of renal functions and prophylaxis/treatment of infection are particularly important in critical care management after liver transplantation. As early postoperative period of liver transplantation is a critical phase; close monitoring, stabilization of cardiopulmonary functions, frequent evaluation of graft function, early diagnosis of complications and rapid treatment of extrahepatic organ failure are mandatory in order to reduce mortality/morbidity.

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Section: Pulmoner Sorunlar Ve Solunumsal Yönetimunclassified

Critical Care Management after Adult Liver Transplantation

Akan¹

2017

tybdd

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“…The first postoperative year seems to be responsible for most of the weight gained after the operation 8,10,22 . Patients seem to recover most of the weight lost during liver disease already in the first post-transplant year; 45% of them are overweight at the end of the first year versus 21% at the first post-transplant outpatient visit, and 43% prior to liver disease 23 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…There are few data on food intake in liver transplant recipients. Nevertheless, none of the studies showed an association of dietary caloric intake with weight changes 8,10,11,25 . This is possibly due to the methods used, since intake is usually assessed at the time of data collection and not continuously.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…In the study by Anastácio et al 25 , 41.5% of the individuals were thus classified, and 88% had some degree of abdominal obesity (waist circumference greater than 80cm for women and 90cm for men) 25 . FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO FACTORS ASSOCIATED TO WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT WEIGHT GAIN, OVERWEIGHT AND OBESITY AND OBESITY AND OBESITY AND OBESITY AND OBESITY The factors described are often older age 8,29 , family history of overweight, high BMI prior to the disease 8,22,30 , post-transplant hypometabolism 8,10 , post-transplant physical inactivity 10 , high donor BMI 22 , being married 22,25 , few hours slept 25 and less dietary calcium intake 25 . Some authors demonstrated greater weight gain in patients undergoing liver transplantation for chronic liver diseases compared with those who were transplanted due to fulminant hepatic failure 8 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…There are reports on obesity in 40% of the population already in the first post-transplant year 7 , and after three years of operation about 70% of patients have excess body weight 8 . Although no study has been able to demonstrate the relationship between overeating and posttransplant weight gain [9][10][11][12] , it is known that patients undergoing liver transplantation rediscover the appetite and pleasure of old eating habits after months of restrictions 13 . Also, they feel better and are able to feed in appreciable quantities.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

See 2 more Smart Citations

Excesso de peso em pacientes submetidos ao transplante hepático

Anastácio

Angelis-Pereira

Vilela

et al. 2013

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTThis review aims to describe the incidence and prevalence of overweight and obesity after liver transplantation and the consequences associated with it. Literature review consultation was conducted in Medline / PubMed, SciELO, EMBASE and LILACS, with the combination of the following keywords: liver transplantation, overweight, obesity, weight gain. Overweight is incident on more than 60% of patients undergoing liver transplantation and obesity rates exceed 20% in the first year after surgery, during which occurs the largest relative weight gain. Studies have shown that between 60% and 70% of patients undergoing liver transplantation are overweight after the third year, 90% with abdominal obesity. Associated factors are, among others, advanced age, family history of overweight and excess weight prior to liver disease. The contribution of immunosuppressive medication remains controversial. Some of the consequences of overweight are liver steatosis, steatohepatitis, diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease and death.

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