Extravascular Lung Water and Pulmonary Vascular Permeability Index Measured at the End of Surgery Are Independent Predictors of Prolonged Mechanical Ventilation in Patients Undergoing Liver Transplantation

Garutti, Ignacio; Sanz, Javier; Olmedilla, Luis; Tranche, Itziar; Vilchez, A.; Fernández-Quero, L; Bañares, Rafael; Pérez-Peña, Jose

doi:10.1213/ane.0000000000000875

Cited by 28 publications

(21 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…From a translational point of view, we evaluated the relationship between PGE 2 levels in plasma and the clinical data of patients undergoing LT . Interestingly, clinical data obtained in the context of LT showed a significant association between arterial PGE 2 levels and early graft function, evaluated by a well‐known scale that has been employed in previous publications . Additionally, ischemia time was inversely associated to PGE 2 .…”

Section: Discussionmentioning

confidence: 99%

Protective Role of Hepatocyte Cyclooxygenase‐2 Expression Against Liver Ischemia–Reperfusion Injury in Mice

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Protective Role of Hepatocyte Cyclooxygenase‐2 Expression Against Liver Ischemia–Reperfusion Injury in Mice

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Adult publications often utilize a 48 hr cut-point [8, 9]. This may not necessarily be a practical cut-point in children.…”

Section: Methodsmentioning

confidence: 99%

Factors Associated with Postoperative Prolonged Mechanical Ventilation in Pediatric Liver Transplant Recipients

Nafiu

Carello

Lal

et al. 2017

Anesthesiology Research and Practice

View full text Add to dashboard Cite

Introduction Almost all pediatric orthotopic liver transplant (OLT) recipients require mechanical ventilation in the early postoperative period. Prolonged postoperative mechanical ventilation (PPMV) may be a marker of severe disease and may be associated with morbidity and mortality. We determined the incidence and risk factors for PPMV in children who underwent OLT. Methods This was a retrospective analysis of data collected on 128 pediatric OLT recipients. PPMV was defined as postoperative ventilation ≥ 4 days. Perioperative characteristics were compared between cases and control groups. Multivariable logistic regression analysis was used to calculate odds ratios for PPMV after controlling for relevant cofactors. Results An estimated 25% (95% CI, 17.4%–32.6%) required PPMV. The overall incidence of PPMV varied significantly by age group with the highest incidence among infants. PPMV was associated with higher postoperative mortality (p = 0.004) and longer intensive care unit (p < 0.001) and hospital length of stay (p < 0.001). Multivariable analysis identified young patient age, preoperative hypocalcemia, and increasing duration of surgery as independent predictors of PPMV following OLT. Conclusion The incidence of PPMV is high and it was associated with prolonged ICU and hospital LOS and higher posttransplant mortality. Surgery duration appears to be the only modifiable predictor of PPMV.

show abstract

“…The influence of extrahepatic comorbidities in relevant outcomes during and after LT is well recognized . However, the evaluation of cardiac abnormalities in this context is challenging due to specific cirrhosis‐related hemodynamic features and to the absence of a precise definition of cirrhotic cardiomyopathy .…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Troponin Elevation in Liver Transplantation Is Independently Associated With Mortality: A Prospective Observational Study

Vilchez-Monge

Garutti

Jimeno³

et al. 2020

Liver Transpl

Self Cite

View full text Add to dashboard Cite

Intraoperative factors implicated in postoperative mortality after liver transplantation (LT) are poorly understood. Because LT is a particularly demanding procedure, we hypothesized that intraoperative myocardial injury may be frequent and independently associated with early postoperative outcomes. We aimed to determine the association between intraoperative high-sensitivity troponin (hsTn) elevation during LT and 30-day postoperative mortality. A total of 203 adult patients undergoing LT were prospectively included in the cohort and followed during 1 year. Advanced hemodynamic parameters and serial high-sensitivity troponin T (hsTnT) measurements were assessed at 6 intraoperative time points. The optimal hsTnT cutoff level for intraoperative troponin elevation (ITE) was identified. Patients were classified into 2 groups according to the presence of ITE. Independent impact of ITE on survival was assessed through survival curves and multivariate Cox regression analysis. Intraoperative cardiac function was compared between groups. Troponin levels increased early during surgery in the ITE group. Troponin values at abdominal closure were associated with 30-day mortality (area under the receiver operating caracteristic curve, [AUROC], 0.73; P = 0.005). Patients with ITE showing values of hsTnT ≥61 ng/L at abdominal closure presented higher 30-day mortality (29.6% versus 3.4%; P < 0.001). ITE was independently associated with 30-day mortality (hazard ratio, 3.8; 95% confidence interval, 1.1-13.8; P = 0.04) and with worse overall intraoperative cardiac function. The hsTnT upper reference limit showed no discriminant capacity during LT. Intraoperative myocardial injury identified by hsTn elevation is frequently observed during LT, and it is associated with myocardial dysfunction and short-term mortality. Determinations of hsTn may serve as a valuable intraoperative monitoring tool during LT. Liver Transplantation 26 681-692 2020 AASLD.Despite improvements in surgical techniques and clinical management, early postoperative mortality following liver transplantation (LT) remains a clinically relevant problem accounting for a large proportion of deaths after LT. It has been estimated that 60% of deaths or graft losses within the first year may be directly related to intraoperative or postoperative complications or to development of infection. (1) However, available information regarding intraoperative factors that could be directly implicated in postoperative mortality after LT is scarce. (2) One relevant intraoperative factor potentially implicated in clinical Vilchez-MOnge et al. Abbreviations: 95% CI, 95% confidence interval; AKI, acute kidney injury; AUC, area under the curve; AUROC, area under the receiver operating caracteristic curve; BAR, balance-of-risk; BMI, body mass Address reprint requests to Almudena L. Vilchez-Monge, M.D.

show abstract

Extravascular Lung Water and Pulmonary Vascular Permeability Index Measured at the End of Surgery Are Independent Predictors of Prolonged Mechanical Ventilation in Patients Undergoing Liver Transplantation

Abstract: PVPI and ELWI values obtained at the end of OLT are useful for predicting the need for postoperative PMV.

Cited by 28 publications

References 38 publications

Protective Role of Hepatocyte Cyclooxygenase‐2 Expression Against Liver Ischemia–Reperfusion Injury in Mice

Protective Role of Hepatocyte Cyclooxygenase‐2 Expression Against Liver Ischemia–Reperfusion Injury in Mice

Factors Associated with Postoperative Prolonged Mechanical Ventilation in Pediatric Liver Transplant Recipients

Intraoperative Troponin Elevation in Liver Transplantation Is Independently Associated With Mortality: A Prospective Observational Study

Contact Info

Product

Resources

About