[Evolution in the postoperative intensive care of patients with liver transplantation]

As liver transplantation has evolved (receptor selection, surgical technique, immunosuppressant treatment, etc.), experience has increased and nursing care has evolved. The admission of a patient to the ICU after liver transplantation no longer requires changes in nursing schedules to ensure proper patient care. This study was undertaken to evaluate differences in the evolution of nursing care in two consecutive groups of patients. A retrospective study was made of all nursing and medical records for two patient groups: patients who underwent transplantation in 1994-95 (G-I) and patients who underwent transplantation in 1996-98 (G-II). Medical history, surgical incidents and postoperative evolution (care treatment and complications) were evaluated for every patient. Mean age was similar for both groups, 57.7 years. The patients in the 1996-98 group had a shorter ICU stay, 3.5 days vs. 4.4 days for the 1994-95 group (p < 0.05). Oral feeding was tolerated soon in all patients, but somewhat earlier for the patients in the 1996-98 group. The infection rate (respiratory, urinary, vascular catheter) was low; there were no surgical wound infections. The average number of bacteriological controls was lower in the 1996-98 group, 5 vs. 19 for the 1994-95 group (p < 0.05). Other parameters were similar in both groups. In conclusion, the shorter ICU stay and elimination of routine analyses over the years benefited patients, reduced costs, and increased the availability of ICU beds. This was achieved without any reduction in the quality of care or results obtained.