科研之友
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摘要
Background. Preoperative body mass index (pre-BMI) affecting patients' recovery from orthotropic liver transplantation (OLT) is controversial. Pre-BMI measurements may be exaggerated by ascites. Aim of the study was the assessment of early outcome associated with pre-BMI and ascites.
Methods. Postoperative BM I values and ascites volumes of 206 patients undergoing OLT (2006-2007) were reviewed.
Results. There were 141 preoperatively "non-obese" patients (pre-BMI <= 30 kg/m(2)) and 65 "obese" patients (pre-BMI >30 kg/m(2)). Demographics and model for end-stage liver disease scores were similar for both groups. The mean volume of ascites removed from the "non-obese" patients was significantly larger compared to the "obese" ones (P=0.018). Seventeen "obese" patients became "non-obese" postoperatively. The duration of anesthesia, ischemia, surgery, hemodynamic parameters, estimated blood loss and transfused products were similar for both groups. Ascites volumes correlated significantly (P<0.05) with various intraoperative indices but not pre-BMI. At 24 h postoperatively, the extubation rate was better for the "obese" group (99%) versus the "non-obese" group (93%, P=0.03). However, "non-obese" patients were extubated earlier than the "obese" both by 6 h (45% versus 22%, respectively, P<0.01) and by 12 h (88% versus 74%, respectively, P=0.012). The postoperative, but not the preoperative BMI, correlated with extubation rate <= 6 h (r=0.924, P=0.0001). No "obese" patients died <1 month postoperatively, compared to 9 "non-obese" patients (P<0.01). Intensive Care Unit and hospital stay were similar to 25% longer for the "obese" group.
Conclusion. Pre-OLT BMI does not correlate with ascites or postoperative BMI, nor does it affect duration of ventilation, especially <6 h after surgery. These results dissociate ascites from pre- and post-OLT. (Minerva Anestesiol 2012;78:910-9)
- 出版日期2012-8
