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العنوان
Predictors of Success of Immediate Tracheal Extubation in Living Donor Liver Transplantation Recipients
الناشر
faculty of medicine
المؤلف
Ibrahim,Douaa Galal Mohammad Mohammad
هيئة الاعداد
باحث / دعاء جلال محمد محمد إبراهيم
مشرف / الأستاذ الدكتور/ جمـال فـؤاد صالـح ذكـي
مشرف / الدكتورة/ إيمـان محمد كمال أبوسيف
مشرف / الدكتورة/ داليا محمود أحمد الفاوي
مشرف / لدكتور/ عمـرو محمد هلال
الموضوع
Immediate Tracheal Extubation Living Donor Liver Transplantation Recipients
تاريخ النشر
2019
عدد الصفحات
119 P.
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
التخدير و علاج الألم
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - التخدير
الفهرس
Only 14 pages are availabe for public view

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from 118

Abstract

Background: Early tracheal extubation of recipients following liver transplantation (LT) has been promoted and gradually replacing standard postoperative prolonged mechanical ventilation, possibly contributing to better graft and patient survival and reduced costs. There are no universally accepted predictors of success of immediate extubation in LT recipients. We hypothesized a number of factors as predictors of successful immediate tracheal extubation in living donor liver transplantation (LDLT) recipients.
Aim: The aim of this study was to evaluate the validity of the following hypothesized factors: Model for end stage liver disease (MELD) score, duration of surgery, number of intraoperatively transfused packed red blood cells (RBCs) units and end of surgery (EOS) serum lactate, as predictors of success of immediate tracheal extubation in living donor liver transplantation (LDLT) recipients.
Methods: In this prospective clinical trial, perioperative data of adult LDLT recipients were recorded. “Immediate extubation” was defined as tra¬cheal extubation immediately and up to 1 hour postransplant in the operating room. Patients were divided into; extubated group who were successfully extubated with no need for reintubation, and non-extubated group who failed to meet criteria of extubation or were re-intubated within 4 hours of extubation.
Results: Of 64 patients, 50 (76.9%) were extubated early after LDLT while 14 (23.07%) were transported to the intensive care unit (ICU) intubated. After data analysis, it was found that EOS serum lactate, duration of surgery and number of packed RBCs units transfused intraoperatively, were good predictors of success of immediate extubation, while MELD scores had no statistically significant impact on the results. In addition, other factors such as EOS urine output and pH were shown to have significantly affected the results.
Conclusions: EOS serum lactate, duration of surgery and number of packed RBCs units transfused were predictors of post-transplant early extubation.