Abstract:
BACKGROUND:Acute kidney injury (AKI) occurs frequently after liver transplant surgery and is associated with significant morbidity and mortality. While the impact of intraoperative hypotension (IOH) on postoperative AKI has been well demonstrated in patients undergoing a wide variety of non-cardiac surgeries, it remains poorly studied in liver transplant surgery. We tested the hypothesis that IOH is associated with AKI following liver transplant surgery. METHODS:This historical cohort study included all patients who underwent liver transplant surgery between 2014 and 2019 except those with a preoperative creatinine > 1.5 mg/dl and/or who had combined transplantation surgery. IOH was defined as any mean arterial pressure (MAP) < 65 mmHg and was classified according to the percentage of case time during which the MAP was < 65 mmHg into three groups, based on the interquartile range of the study cohort: "short" (Quartile 1, < 8.6% of case time), "intermediate" (Quartiles 2-3, 8.6-39.5%) and "long" (Quartile 4, > 39.5%) duration. AKI stages were classified according to a "modified" "Kidney Disease: Improving Global Outcomes" (KDIGO) criteria. Logistic regression modelling was conducted to assess the association between IOH and postoperative AKI. The model was run both as a univariate and with multiple perioperative covariates to test for robustness to confounders. RESULTS:Of the 205 patients who met our inclusion criteria, 117 (57.1%) developed AKI. Fifty-two (25%), 102 (50%) and 51 (25%) patients had short, intermediate and long duration of IOH respectively. In multivariate analysis, IOH was independently associated with an increased risk of AKI (adjusted odds ratio [OR] 1.05; 95%CI 1.02-1.09; P < 0.001). Compared to "short duration" of IOH, "intermediate duration" was associated with a 10-fold increased risk of developing AKI (OR 9.7; 95%CI 4.1-22.7; P < 0.001). "Long duration" was associated with an even greater risk of AKI compared to "short duration" (OR 34.6; 95%CI 11.5-108.6; P < 0.001). CONCLUSIONS:Intraoperative hypotension is independently associated with the development of AKI after liver transplant surgery. The longer the MAP is < 65 mmHg, the higher the risk the patient will develop AKI in the immediate postoperative period, and the greater the likely severity. Anesthesiologists and surgeons must therefore make every effort to avoid IOH during surgery.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Joosten A,Lucidi V,Ickx B,Van Obbergh L,Germanova D,Berna A,Alexander B,Desebbe O,Carrier FM,Cherqui D,Adam R,Duranteau J,Saugel B,Vincent JL,Rinehart J,Van der Linden Pdoi
10.1186/s12871-020-01228-ysubject
Has Abstractpub_date
2021-01-11 00:00:00pages
12issue
1issn
1471-2253pii
10.1186/s12871-020-01228-yjournal_volume
21pub_type
杂志文章abstract:BACKGROUND:In patients with subarachnoid hemorrhage (SAH), vasospasm remains one of the major complications. The application of intravenous magnesium sulfate (MgSO4) has been under discussion to prevent cerebral ischemia. Our aim was to examine the impact of early MgSO4 administration on local cerebral microcirculation...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0435-y
更新日期:2017-10-17 00:00:00
abstract:BACKGROUND:There are growing concerns that anaesthetic exposure can cause extensive apoptotic degeneration of neurons and the impairment of normal synaptic development and remodelling. However, little attention has been paid to exploring the possible cytotoxicity of inhalation anaesthetics, such as isoflurane, in astro...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0420-5
更新日期:2017-09-05 00:00:00
abstract:BACKGROUND:Isoflurane-induced neuroapoptosis and cognitive impairment has been previously reported. Hydrogen sulfide (H2S) has been shown to be a neuromodulator that is thought to have anti-apoptotic, anti-inflammatory, and anti-oxidative benefits. However, it is not known if H2S is protective against anesthesia-induce...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0419-y
更新日期:2017-09-05 00:00:00
abstract:BACKGROUND:Aspiration-induced lung injury can decrease gas exchange and increase mortality. Acute lung injury following acid aspiration is characterized by elevated pulmonary blood flow (PBF) in damaged lung areas in the early inflammation stage. Knowledge of PBF patterns after acid aspiration is important for targetin...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-015-0013-0
更新日期:2015-03-18 00:00:00
abstract:BACKGROUND:Patients in intensive care units (ICUs) are often physically unable to communicate with their physicians. Thus, the sharing of information about the on-going treatment of the patients in ICUs is directly related to the communication attitudes governing a patient's relatives and the physician. This study aims...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/s12871-017-0388-1
更新日期:2017-07-17 00:00:00
abstract:BACKGROUND:Spinal block is a common procedure for lower limbs surgery. Fentanyl, a synthetic opioid and dexmedetomidine, a selective α2 agonist have been used as adjuvants in spinal anesthesia to prolong intraoperative and postoperative analgesia. The aim of current study is to compare the efficacy of dexmedetomidine a...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0531-7
更新日期:2018-06-06 00:00:00
abstract:BACKGROUND:No study has been conducted to demonstrate the feasibility of an opioid-free anesthesia (OFA) protocol in cardiac surgery to improve patient care. The aim of the present study was to evaluate the effect of OFA on post-operative morphine consumption and the post-operative course. METHODS:After retrospectivel...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0802-y
更新日期:2019-07-31 00:00:00
abstract:BACKGROUND:Local anesthetic Bupivacaine commonly used in gastric cancer resection operation has been reported to suppress the progression of gastric cancer. However, the specific mechanism by which Bupivacaine functions is largely unexplored. METHODS:The viability and metastasis of gastric cancer cells were assessed b...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01179-4
更新日期:2020-10-30 00:00:00
abstract:BACKGROUND:Fluid overloading is detrimental to organ function and results in a poor prognosis. It is necessary to evaluate fluid responsiveness before fluid loading. We performed a systematic meta-analysis to evaluate the diagnostic value of the respiratory variation in peripheral arterial blood flow peak velocity (△Vp...
journal_title:BMC anesthesiology
pub_type: 杂志文章,meta分析
doi:10.1186/s12871-018-0635-0
更新日期:2018-11-13 00:00:00
abstract:BACKGROUND:Sugammadex reverses neuromuscular block (NMB) through binding aminosteroid neuromuscular blocking agents. Although sugammadex appears to be highly selective, it can interact with other drugs, like corticosteroids. A prospective single-blinded randomized clinical trial was designed to explore the significance...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0254-6
更新日期:2016-10-21 00:00:00
abstract:BACKGROUND:This paper describes the design of a multifunction alerting display for intraoperative anesthetic care. The design was inspired by the multifunction primary flight display used in modern aviation. RESULTS:The display retrieves live data from multiple sources; the physiologic monitors, the anesthesia informa...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0478-8
更新日期:2018-02-05 00:00:00
abstract:BACKGROUND:Effectiveness of the donation request is generally measured by consent rates, rather than by relatives' satisfaction with their decision. Our aim was to elicit Dutch ICU staffs' views and experiences with the donation request, to investigate their awareness of (dis)satisfaction with donation decisions by rel...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-52
更新日期:2014-07-11 00:00:00
abstract:BACKGROUND:Even the best cancer surgery is usually associated with minimal residual disease. Whether these remaining malignant cells develop into clinical recurrence is at least partially determined by adequacy of host defense, especially natural killer cell function. Anesthetics impair immune defenses to varying degre...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-9-1
更新日期:2009-02-03 00:00:00
abstract:BACKGROUND:During an emergency endotracheal intubation, rapid sequence induction intubation (RSII) with cricoid pressure (CP) is frequently implemented to prevent aspiration pneumonia. We evaluated the CVS in endotracheal intubation in RSII with CP, in comparison with a direct laryngoscope (DL). METHODS:One hundred fi...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0703-0
更新日期:2019-03-04 00:00:00
abstract:BACKGROUND:The quality of patients' recovery following surgery and anesthesia has been a matter of focus and concern over the past decade. The Quality of Recovery-40 (QoR-40) questionnaire was developed and validated for post-anesthesia patient evaluation. The QoR-40, however, is English-based and was tested and valida...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0229-7
更新日期:2016-08-18 00:00:00
abstract:BACKGROUND:There are doubts among anesthesiologists on the use of the Laryngeal Mask Airway (LMA) in nasal surgeries because of concerns about the occurrence of blood leakages to the airway. We hypothesized that the use of LMA-Supreme (LMA-S) in nasal surgery is comparable with endotracheal tube (ETT) according to airw...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01222-4
更新日期:2021-01-07 00:00:00
abstract:BACKGROUND:The effect of adding clonidine to local anesthetics for nerve or plexus blocks remains unclear. Most of the studies in adults have demonstrated the positive effects of clonidine on intra- and postoperative analgesia when used as an adjunctive agent or in some cases as a single to regional techniques. In the ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-12-2
更新日期:2012-02-01 00:00:00
abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:BMC anesthesiology
pub_type: 已发布勘误
doi:10.1186/s12871-020-01196-3
更新日期:2020-11-09 00:00:00
abstract:BACKGROUND:Lumbar puncture for spinal or epidural anesthesia is commonly performed by palpating bony landmarks, but identification of the desired intervertebral level is often inaccurate. It is unclear whether such inaccuracy is related to patient factors, such as body mass index and degree of lumbar flexion. We hypoth...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-15-9
更新日期:2015-01-21 00:00:00
abstract:BACKGROUND:Quick and complete recovery of cognitive function after general anesthesia is desirable, particularly for working-age patients. Desflurane is less likely to have long-term effects than older-generation inhalational anesthetics, however, its short-term effects have not been fully investigated. Our objective w...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0793-8
更新日期:2019-07-04 00:00:00
abstract:BACKGROUND:Despite international data indicating that Enhanced Recovery After Surgery (ERAS) programs, which combine evidence-based perioperative strategies, expedite recovery after surgery, few centers have successfully adopted this approach within the U.S. We describe the implementation and efficacy of an ERAS progra...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0223-0
更新日期:2016-08-03 00:00:00
abstract:BACKGROUND:Bone cement implantation syndrome is a known complication causing mortality during perioperative period particularly in patients with malignancy. With rise in aging population with malignancy in low income country, the syndrome is more likely to be encountered. CASE PRESENTATION:We present a case of 66 year...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0492-x
更新日期:2018-03-02 00:00:00
abstract:BACKGROUND:Performing spinal anaesthesia using the conventional popping method with a 27-gauge (27G) spinal needle is technically difficult. In this study, we compared the aspiration and conventional popping method for spinal anaesthesia using 27G Quincke-type needles. METHODS:This prospective, randomized study enroll...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-020-0954-9
更新日期:2020-01-30 00:00:00
abstract:BACKGROUND:Perioperative immune function plays an important role in the prognosis of patients. Several studies have indicated that low-dose opioid receptor blockers can improve immune function. METHODS:Sixty-nine patients undergoing video-assisted thoracoscopic resection of the lung cancer were randomly assigned to ei...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0912-6
更新日期:2019-12-19 00:00:00
abstract:BACKGROUND:The timing of laryngeal mask airway (LMA) removal remains undefined. This study aimed to assess the optimal timing for LMA removal and whether topical anesthesia with lidocaine could reduce airway adverse events. METHODS:This randomized controlled trial assessed one-to-six-year-old children with ASA I-II sc...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-021-01235-7
更新日期:2021-01-08 00:00:00
abstract:BACKGROUND:Obstetric dfficult airway is a leading cause of maternal morbidity and mortality. The laryngeal mask airway (LMA) is often used as a rescue airway device after failed intubation, however, little is known about predictors of difficult LMA insertion, particularly in obstetrics. Since Mallampati scores of III/I...
journal_title:BMC anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1186/s12871-019-0796-5
更新日期:2019-07-08 00:00:00
abstract:BACKGROUND:Many cases of coronary artery spasm (CAS) during general plus epidural anesthesia have been reported. But transversus abdominis plane(TAP) block in combination with general anesthesia has not been reported to be a cause of CAS, let alone a life-threatening CAS. CASE PRESENTATION:In this case report, we pres...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0616-3
更新日期:2018-10-20 00:00:00
abstract:BACKGROUND:Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. METHODS:A randomized, double blind, p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2253-14-93
更新日期:2014-10-17 00:00:00
abstract:BACKGROUND:Current pain assessment and treatment does not address every patient's requirements. Although the Polish national guidelines for post-operative pain management have been published, many patients experience severe pain in the postoperative period. The main goal of our study was to assess pain severity among p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/s12871-018-0551-3
更新日期:2018-07-18 00:00:00
abstract:BACKGROUND:Surgical stress index (SSI) is an established indicator for intraoperative nociception. Opioids are used to block stimulus of cranial pinning in neurosurgery. We investigated the effect of different infusion rates of sufentanil on SSI during cranial pinning in children under general anaesthesia. METHODS:For...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0448-6
更新日期:2017-12-08 00:00:00