Liver Transplant Quality and Safety Plan in Anesthesia and Intensive Care Medicine

Rocca, Giorgio Della; Flaviis, Adelisa De; Costa, M. G.; Chiarandini, P.; Pompei, Livia; Venettoni, Sante

doi:10.1016/j.transproceed.2010.05.043

Cited by 7 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(84) Similarly, it is likely that the postoperative pneumonia rate of 15% can be reduced by systematic and intensive pulmonary rehabilitation, such as chest physical therapy, incentive spirometry, early ambulation, short intubation times and other focused interventions, described in general surgery patients. (85) Interestingly the magnitude of the different pooled complication cohorts, seems also reflect the difference in perceived preventability by the transplant community. While biliary complications and infections have large pooled cohorts, pulmonary complications are noticeably smaller.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of complications following deceased donor liver transplant

McElroy¹,

Daud²,

Davis³

et al. 2014

The American Journal of Surgery

View full text Add to dashboard Cite

Background Liver transplantation is a complex surgery associated with high rates of postoperative complications. While national outcomes data are available, national rates of most complications are unknown. Data Sources A systematic review of the literature reporting rates of postoperative complications between 2002 and 2012 was performed. A cohort of 29,227 deceased donor liver transplant recipients from 74 studies was used to calculate pooled incidences were for 17 major postoperative complications. Conclusions This is the first comprehensive review of postoperative complications after liver transplantation and can serve as a guide for transplant and non-transplant clinicians. Efforts to collect national data on complications, such as through the National Surgical Quality Improvement Program, would improve the ability to provide patients with informed consent, serve as a tool for individual center performance monitoring, and provide a central source against which to measure interventions aimed at improving patient care.

show abstract

Section: Discussionmentioning

confidence: 99%

A meta-analysis of complications following deceased donor liver transplant

McElroy¹,

Daud²,

Davis³

et al. 2014

The American Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…During the progress of each stage, we sought to include evidence from the literature, suggestions from experts, as well as changes presented by the judges in order to ensure a tool that supports the multidisciplinary team in the safety of this procedure. Above all, this tool addresses the requirements of ANVISA through bio-surveillance (10) , providing, in the postoperative period, better graft functionality and restoration of the functional activity of the liver and the patient (7)(8)(12)(13)(14)(15) .…”

Section: Discussionmentioning

confidence: 99%

“…As for the evidence in the literature, there were few suggestions for changes in the tool: the data practically points to body temperature, surgical position and use of blood products (12)(13)(14)(15) . The information of professionals with expertise in the area, on the other hand, gave rise to important facts to be checked by the team at all stages of the checklist.…”

Section: Discussionmentioning

confidence: 99%

“…In liver transplantation, anesthetic induction ensures a stable transoperative, a more peaceful anepathic and neohepatic phase, in addition to an effective reperfusion considering the control performed by the anesthesiologist (18)(19)(20) . With regard to checking, the moment "Before starting the surgery", which underwent the greatest number of adjustments and inclusion of items, the evidence brought data related to body temperature and use of devices (12)(13)(14)(15) . The professionals with expertise highlighted factors related to the donor and recipient, items related to rapid infusion and care for the prevention of complications such as pressure injury and thrombosis.…”

Section: Nursementioning

confidence: 99%

“…Regarding the safety of this procedure, the category "Before the patient leaves the operating room" on the Liver Transplant checklist proposed: adjustments directed to the verification and confirmation of equipment that can propose safety in transporting the patient from the surgical environment to the Intensive Care Unit (ICU); as well as the adjustments related to the checking of hemodynamic stability and complications that may compromise their arrival at the ICU. The checking of these items at the end of the surgery provides early extubation, which can also occur in the operating room, and minimizes the risk of cardiac arrhythmias, postoperative infections and cardiopulmonary arrest during the journey to the ICU (12)(13)(14)(15)28) .…”

Section: Nursementioning

confidence: 99%

See 2 more Smart Citations

Safe surgery checklist: content validation proposal for liver transplantation

et al. 2020

View full text Add to dashboard Cite

Objectives: to develop the safe surgery checklist for liver transplantation according to the original model of the World Health Organization and perform content validation. Methods: a methodological research developed in four stages: integrative review; expert participation; consensus among researchers; and content validation using the Delphi technique in two rounds, by five judges. For data analysis, the Content Validation Index was used. Results: the first version of the checklist consisted of four surgical moments with 64 items of verification, with an average Content Validation Index of 0.80. After adjustments, in the second round the checklist maintained four surgical moments with 76 items and a Content Validation Index of 0.87. Conclusions: the checklist was validated and adequate for the safety of liver transplantation in the surgical environment, given that each item established must be mapped and managed for the success and effectiveness of the procedure.

show abstract