麻醉和临床护理用于预测和预防小规模综合征:来自ILTS-iLDLT-LTSI共识会议的指南
Ryan Chadha1, Tetsuro Sakai2, Akila Rajakumar3
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL.
Transplantation
|September 26, 2023
概括
麻醉科医生应仔细管理接受小肝移植的患者,以防止小于大小的综合征 (SFSS). 建议涵盖术后护理,包括流体策略和监测,以优化活体供体肝移植的结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植手术 移植手术
- 麻醉学 麻醉学
背景情况:
- 活体供体肝移植 (LDLT) 在移植体大小不足时,会带来小于尺寸综合征 (SFSS) 的风险.
- SFSS可能会导致接受者出现严重的术后并发症.
研究的目的:
- 在LDLT期间制定基于证据的建议,用于管理患有SFSS风险的患者.
- 为风险患者提供外科手术前期麻醉和重症监护的框架.
主要方法:
- 来自21个国家的106名专家组成的科学委员会进行了广泛的文献审查.
- 通过盲目专家小组审查和共识会议来完善建议.
主要成果:
- 经验丰富的中心应该谨慎地考虑在高风险受体中利用潜在的小规模移植.
- 术内管理包括限制性流体策略,心脏输出监测和门户流量调节.
- 术后护理强调增强恢复,积极的SFSS监测,营养,感染预防,以及早期考虑脏替代疗法.
结论:
- 这些建议为患有SFSS风险的患者的术后护理提供了管理框架.
- 证据存在显著的局限性,突出了未来对SFSS外科手术管理的研究的需要.
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