Teijeiro PR, Fonseca LJA, Rivero SE, Domínguez CG, Vilatobá CM

Language: Spanish
References: 20
Page: 290-300
PDF size: 237.30 Kb.

ABSTRACT

The resuscitation period after orthotopic liver transplantation (OLT) is challenging due to the physiological alterations related to end stage liver disease (ESLD).
Material and methods: This is a retrospective study assessing the first 48 hours management at the intensive care unit (ICU) of at hospital in México City. Patients were categorized into 4 groups according to norepinephrine (NADR) dose used and net fluid balance (BalT): group 1 norepinephrine ‹ 0.1 µg/1 kg/min/BalT 3,805 mL, group 2 norepinephrine › 0.1 µg/kg/min/BalT ‹ 3,805 mL, group 3 norepinephrine ‹ 0.1 µg/kg/min/BalT › 3,805 mL, group 4 norepinephrine › 0.1 µg/kg/min/BalT › 3,805 mL. The relationship with the development of Po-OLT complications was assessed. Primary endpoints were general medical complications, surgical reoperation, and length of stay (LOS), length of mechanical ventilation, acute kidney injury, abnormal graft function and positive cultures.
Results: 36.6% of the patients belonged to group 1, 18.8% to group 2, 17.8% to group 3, and 26.7% to group 4. The length of stay was 3.39 days, mean time of mechanical ventilation of 16.5 hours. 67% developed medical complications, 15.8% surgical reoperation, 62% acute kidney injury, 50.5% abnormal graft function and 45.5% positive perioperative cultures. Of these primary endpoints, only length of stay and length of mechanical ventilation were different among groups.
Conclusions: Length of stay and mechanical ventilation need was different among groups. Development of other primary endpoints was independent of the resuscitation model.

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