Preemptive Thoracic Drainage to Eradicate Postoperative Pulmonary Complications after Living Donor Liver Transplantation

Imai, Daisuke; Ikegami, Toru; Toshima, Takeo; Yoshizumi, Tomoharu; Yamashita, Yo Ichi; Ninomiya, Mizuki; Harimoto, Norifumi; Itoh, Shinji; Uchiyama, Hideaki; Shirabe, Ken; Maehara, Yoshihiko

doi:10.1016/j.jamcollsurg.2014.09.006

Cited by 9 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since then, the concept has seen little attention and at the time of publication there was only 1 existing study on a preemptive approach for CD insertion before LT: in a living donor LT cohort in Japan; Imai et al analyzed risk factors for postoperative atelectasis and accordingly performed preoperative thoracic drainage if risk factors were present. They demonstrated that the group with preemptive thoracic drainage for at-risk patients showed significantly less atelectasis after LT, contracted pneumonia at a lower incidence and had a shorter ICU stay [28]. Despite major differences in LT between Japan and Germany (e.g., percentage of living donor transplantations [53]) these findings support the concept of preemptive CD to reduce morbidity.…”

Section: Discussionmentioning

confidence: 95%

Perioperative Pleural Drainage in Liver Transplantation: A Retrospective Analysis from a High-Volume Liver Transplant Center

et al. 2020

View full text Add to dashboard Cite

Background: Pleural effusions represent a common complication after liver transplantation (LT) and chest drain (CD) placement is frequently necessary. Material/Methods: In this retrospective cohort study, adult LT recipients between 2009 and 2016 were analyzed for pleural effusion formation and its treatment within the first 10 postoperative days. The aim of the study was to compare different settings of CD placement with regard to intervention-related complications. Results: Overall, 597 patients met the inclusion criteria, of which 361 patients (60.5%) received at least 1 CD within the study period. Patients with a MELD >25 were more frequently affected (75.7% versus 56.0%, P<0.001). Typically, CDs were placed in the intensive care unit (ICU) (66.8%) or in the operating room (14.1% during LT, 11.5% in the context of reoperations). In total, 97.0% of the patients received a right-sided CD, presumably caused by local irritations. Approximately one-third (35.4%) of ICU-patients required pre-interventional optimization of coagulation. Of the 361 patients receiving a CD, 15 patients (4.2%) suffered a post-interventional hemorrhage and 6 patients (1.4%) had a pneumothorax requiring further treatment. Less complications were observed when the CD was performed in the operating room compared to the ICU: 1 out 127 patients (0.8%) versus 20 out of 332 patients (6.0%); P=0.016. Conclusions: CD placement occurring in the operating room was associated with fewer complications in contrast to placement occurring in the ICU. Planned CD placement in the course of surgery might be favorable in high-risk patients.

show abstract

Section: Discussionmentioning

confidence: 95%

Perioperative Pleural Drainage in Liver Transplantation: A Retrospective Analysis from a High-Volume Liver Transplant Center

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Imai and associates 26 showed that the incidence of pneumonia was significantly higher in liver transplant recipients with grade ≥ 2 postoperative atelectasis than without (18.4% versus 1.6%; P = .002). Similarly, our study reported that patients with atelectasis grade ≥ 2 had higher risk of posttransplant early pneumonia (RR = 8.2, 95% CI, 2.56-26.29; P ≤ .001).…”

Section: Discussionmentioning

confidence: 98%

“…These neurologic complications may result in prolonged ICU stay and immobilization. Imai and associates 26 showed that performance status ≥ 3 was a risk factor for postoperative pulmonary complications (odds ratio = 7.1, 95% CI, 2.0-28.0; P = .003). According to the Eastern Cooperative Oncology Group scale of performance status, a performance status ≥ 3 indicates that a patient is bedridden for greater than 50% of the day.…”

Section: Discussionmentioning

confidence: 98%

Untitled

El-Badrawy

Ali²,

Yassen³

et al. 2017

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Pneumonia has a negative effect on the outcome of liver transplant. Our aim was to analyze early-onset pneumonia that developed within the first month after transplant. Materials and Methods:This prospective single-center study included 56 adult living-donor liver transplant recipients; those who developed early-onset pneumonia based on clinical and radiologic criteria were investigated as to causative pathogens and then followed up and compared with other recipients without pneumonia to illustrate risk factors, outcomes, and related mortality of posttransplant pneumonia. Results: Twelve patients (21.4%) developed early-onset pneumonia with mortality rate of 75% (9 of 12). Sixteen pathogens were isolated; extended spectrum beta-lactamase producing Enterobacteriaceae were the most common (31.2%) followed by carbapenemproducing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus (18.8%). Fungi were isolated in 3 cases that were also coinfected with bacteria. Diabetes mellitus (P = .042), liberal postoperative fluid therapy (P = .028), prolonged posttransplant intensive care unit stay (P = .01), atelectasis grade ≥ 2 (P ≤ .001), and calcineurin inhibitor-induced neurotoxicity (P = .04) were risk factors for early posttransplant pneumonia. Conclusions: Pneumonia is the leading cause of early mortality after liver transplant. The emergence of multidrug-resistant bacteria is major issue associated with a high rate of treatment failure.

show abstract

“…However, lung cancer surgery is associated with a high incidence of postoperative pulmonary complications (PPCs) with a reported incidence of 15.8-31.7% based on large sample studies [1,2]. This is higher than the incidence for other major surgical procedures such as orthopedic surgery (0.3-3.6%), cardiac surgery (1.5-28.4%), upper and lower abdominal surgery (1.8-23.7% and 1.9-4.3%) [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The term PPC is defined as clinically significant respiratory complication or dysfunction requiring medical and rehabilitation intervention.…”

Section: Introductionmentioning

confidence: 99%

Does a pulmonary rehabilitation based ERAS program (PREP) affect pulmonary complication incidence, pulmonary function and quality of life after lung cancer surgery? Study protocol for a multicenter randomized controlled trial

Zheng

Mao

et al. 2020

BMC Pulm Med

View full text Add to dashboard Cite

Background: Lung cancer surgery is associated with a high incidence of postoperative pulmonary complications (PPCs). Preliminary evidence suggests that ERAS processes can reduce overall incidence of PPCs as short-and longterm recovery improved by supporting units to adopt evidence-based care. However, the evidence is inconclusive due to insufficient high-level studies in this research field. No well-designed, adequately powered, randomized controlled trials (RCTs) have investigated the effects of pulmonary rehabilitation based ERAS program (PREP) on post-operative pulmonary complications, pulmonary function, and health related quality of life following lung cancer surgery. Methods:The PREP trial is a pragmatic, investigator-initiated, multi-center, randomized controlled, parallel group, clinical trial. Five hundred patients scheduled for minimally invasive pulmonary resection at six hospitals in China will be randomized with concealed allocation to receive either i) a pre-operative assessment and an information booklet or ii) a pre-operative assessment, an information booklet, plus an additional education, a 30-min pulmonary rehabilitation training session and the post-operative pulmonary rehabilitation program. The primary outcome is incidence of PPCs defined with the Melbourne Group Scale diagnostic scoring tool. Secondary outcomes include incidence of cardiopulmonary and other complications, pulmonary function, cardiopulmonary endurance, muscle strength, activity level, health-related quality of life (HRQoL), pre-and post-operative hospital length of stay (LOS), and total hospital LOS. Discussion: The PREP trial is designed to verify the hypothesis that pulmonary rehabilitation based ERAS program reduces incidence of PPCs and improves pulmonary function and HRQoL in patients following lung cancer surgery. This trial will furthermore contribute significantly to the limited knowledge about the pulmonary rehabilitation based ERAS program following lung cancer surgery, and may thereby form the basis of future recommendations in the surgical community.

show abstract

Preemptive Thoracic Drainage to Eradicate Postoperative Pulmonary Complications after Living Donor Liver Transplantation

Cited by 9 publications

References 31 publications

Perioperative Pleural Drainage in Liver Transplantation: A Retrospective Analysis from a High-Volume Liver Transplant Center

Perioperative Pleural Drainage in Liver Transplantation: A Retrospective Analysis from a High-Volume Liver Transplant Center

Untitled

Does a pulmonary rehabilitation based ERAS program (PREP) affect pulmonary complication incidence, pulmonary function and quality of life after lung cancer surgery? Study protocol for a multicenter randomized controlled trial

Contact Info

Product

Resources

About