Evidence map›Paper›PMID 37919695›Full record

ArticleBMC anesthesiology2023

Factors associated with mechanical ventilation longer than 24 h after liver transplantation in patients at risk for bleeding.

Marta Caballero, Antoni Sabate, Lourdes Perez, Julia Vidal, Enric Reverter, Rosa Gutierrez, Gonzalo Crespo, Judith Penafiel, Annabel Blasi

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01539057 (A Multicenter, Placebo Controlled Study to Evaluate the Efficacy of the Administration of Fibrinogen on Blood Product Requirements in Liver Transplantation), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01539057 phase3unknown statusnot on this map

A Multicenter, Placebo Controlled Study to Evaluate the Efficacy of the Administration of Fibrinogen on Blood Product Requirements in Liver Transplantation

TypeinterventionalSponsorHospital Universitari de BellvitgeRan2012 to 2015Enrolled132ConditionsIntraoperative BleedingArmsFibrinogen, Saline
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Marta CaballeroDepartment of Anaesthesiology, University Hospital of Bellvitge, University of Barcelona Health Campus, IDIBELL, Barcelona, Spain.
Antoni SabateDepartment of Anaesthesiology, University Hospital of Bellvitge, University of Barcelona Health Campus, IDIBELL, Barcelona, Spain. asabatep@ub.edu.
Lourdes PerezDepartment of Anaesthesiology, University Hospital of Bellvitge, University of Barcelona Health Campus, IDIBELL, Barcelona, Spain.
Julia VidalDepartment of Anaesthesiology, Clinic Hospital, University of Barcelona Health Campus, IDIBAPS, Barcelona, Spain.
Enric ReverterDepartment of Hepatology, Hospital Clínic, Barcelona, IDIBAPS, Spain.
Rosa GutierrezDepartment of Anaesthesiology, University Hospital of Cruces, Bilbao, Spain.
Gonzalo CrespoDepartment of Hepatology, Liver Transplant Unit, Hospital Clínic, Barcelona; University of Barcelona; IDIBAPS; CIBERehd, Barcelona, Spain.
Judith PenafielBiostatistics Unit (UBiDi), University of Barcelona Health Campus, IDIBELL, Barcelona, Spain.
Annabel BlasiDepartment of Anaesthesiology, Clinic Hospital, University of Barcelona Health Campus, IDIBAPS, Barcelona, Spain.
Universitat de Barcelona · ESConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESBellvitge University Hospital · ESHospital Clínic de Barcelona · ESHospital de Cruces · ESInstitut d'Investigació Biomédica de Bellvitge · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis risk analysis aimed to explore all modifiable factors associated with prolonged mechanical ventilation (lasting > 24 h) after liver transplantation, based on prospectively collected data from a clinical trial.

methodsWe evaluated 306 candidates. Ninety-three patients were excluded for low risk for transfusion (preoperative haemoglobin > 130 g.l

resultsEarly tracheal extubation was performed in 149 patients (84.7%), and 27 patients (15.3%) required prolonged mechanical ventilation. Reoperations were required for 6.04% of the early extubated patients and 44% of patients who underwent prolonged ventilation (p = 0.001). A MELD score > 23 was the main risk factor for prolonged ventilation. Once modifiable risk factors were adjusted for MELD score, sex, and age, three factors were significantly associated with prolonged ventilation: tranexamic acid (p = 0.007) and red blood cell (p = 0.001) infusion and the occurrence of postreperfusion syndrome (p = 0.004). The median (IQR) ICU stay was 3 (2-4) days in the early extubation group vs. 5 (3-10) days in the prolonged ventilation group (p = 0.001). The median hospital stay was also significantly shorter after early extubation, at 14 (10-24) days, vs. 25 (14-55) days in the prolonged ventilation group (p = 0.001). Eight patients in the early-extubation group (5.52%) were readmitted to the ICU, nearly all for reoperations, with no between-group differences in ICU readmissions (prolonged ventilation group, 3.7%).

conclusionWe conclude that bleeding and postreperfusion syndrome are the main modifiable factors associated with prolonged mechanical ventilation and length of ICU stay, suggesting that trials should explore vasopressor support strategies and other interventions prior to graft reperfusion that might prevent potential fibrinolysis.

trial registrationEuropean Clinical Trials Database (EudraCT 2018-002510-13,) and on ClinicalTrials.gov (NCT01539057).

Indexed as

End Stage Liver DiseaseLiver TransplantationClinical Trials as TopicFemaleHemorrhageHumansIntensive Care UnitsLength of StayMaleRespiration, ArtificialRisk FactorsSeverity of Illness IndexBlood componentsLiver transplantationMechanical ventilationPatient outcomeSurgical Intensive care unit

Identifiers

PMID37919695
PMCPMC10621188
OpenAlexW4388228745

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.