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Title: Impact of surgical technique and analgesia on clinical outcomes after lung transplantation A STROBE-compliant cohort study
Author: Giménez Milà, Marc
Videla, Sebas
Pallarès, Natàlia
Sabaté Pes, Antoni
Parmar, Jasvir
Catarino, Pedro
Tosh, Will
Rafiq, Muhammad Uma
Nalpon, Jacinta
Valchanov, Kamen
Keywords: Trasplantament d'òrgans
Malalties dels pulmons
Transplantation of organs
Pulmonary diseases
Issue Date: 13-Nov-2020
Publisher: Wolters Kluwer Health Inc.
Abstract: There is paucity of data on the impact of surgical incision and analgesia on relevant outcomes. A retrospective STROBE-compliant cohort study was performed between July 2007 and August 2017 of patients undergoing lung transplantation. Gender, age, indication for lung transplantation, and the 3 types of surgical access (Thoracotomy (T), Sternotomy (S), and Clamshell (C)) were used, as well as 2 analgesic techniques: epidural and intravenous opioids. Outcome variables were: pain scores; postoperative hemorrhage in the first 24 hours, duration of mechanical ventilation, and length of stay at intensive care unit (ICU). Three hundred forty-one patients were identified. Thoracotomy was associated with higher pain scores than Sternotomy (OR 1.66, 95% CI: 1.01; 2.74, P: .045) and no differences were found between Clamshell and Sternotomy incision. The median blood loss was 800 mL [interquartile range (IQR): 500; 1238], thoracotomy patients had 500 mL [325; 818] (P < .001). Median durations of mechanical ventilation in Thoracotomy, Sternotomy, and Clamshell groups were 19 [11; 37] hours, 34 [IQR 16; 57.5] hours, and 27 [IQR 15; 50.5] hours respectively. Thoracotomy group were discharged earlier from ICU (P < .001). Thoracotomy access produces less postoperative hemorrhage, duration of mechanical ventilation, and lower length of stay in ICU, but higher pain scores and need for epidural analgesia.
Note: Reproducció del document publicat a:
It is part of: Medicine, 2020 vol. 99, num. 46
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Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Patologia i Terapèutica Experimental)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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