{
    "abstract": "Early extubation is a fundamental element integrated into enhanced recovery protocols in orthotopic liver transplantation (OLT). The aim is to evaluate whether early extubation influences short- and medium-term postoperative morbidity and mortality.\nA cohort of 209 patients who underwent OLT in a tertiary hospital in a period from January 2016 to December 2018 were retrospectively analyzed. Patients were divided into 2 groups: group 1: early extubation in the intensive care unit and group 2: delayed extubation. Mortality is compared between both groups in the first month and first and third year. Postoperative morbidity was also compared.\nPatients in group 1 (n\u00a0=\u00a0165, 79.9%) presented, with statistical significance, lower mortality at 1 month, 1 year, and 3 years; shorter duration of admission to the critical care unit and of hospital stay; lower incidence of surgical reoperation and retransplant; lower rate of transfusion of blood products; fewer pulmonary, digestive, neurologic, cardiologic, hemodynamic, kidney, surgical, infectious, metabolic, thrombotic, vascular, and graft complications; less need for kidney replacement therapy; less refractory ascites; and greater infectious risk. However, no statistically significant differences were found in the need for hospital readmission; in biliary, endocrine, nutritional, hematologic, thrombotic, and hematologic complications; or in graft rejection. In group 1, 6.6% of patients required reintubation. In group 2, 97% of patients could be extubated during the first week; 7.8% required noninvasive mechanical ventilation type bilevel positive airway pressure and 8.1% high flow. Only 2.8% of patients required tracheotomy.\nThe role of early extubation seems key to improve outcomes in OLT because it reduces the incidence of multiple complications and mortality, with low reintubation rates. It is a feasible and safe procedure.",
    "authors": [
        {
            "affiliation": "Virgen del Roc\u00edo University Hospital, Sevilla, Spain. Electronic address: sonia.arnal.sa@gmail.com.",
            "firstname": "Sonia",
            "initials": "S",
            "lastname": "Arnal Garc\u00eda"
        },
        {
            "affiliation": "Virgen del Roc\u00edo University Hospital, Sevilla, Spain.",
            "firstname": "Guiomar",
            "initials": "G",
            "lastname": "Fern\u00e1ndez Castellano"
        },
        {
            "affiliation": "Virgen del Roc\u00edo University Hospital, Sevilla, Spain.",
            "firstname": "Minia",
            "initials": "M",
            "lastname": "Bast\u00f3n Casti\u00f1eiras"
        },
        {
            "affiliation": "Virgen del Roc\u00edo University Hospital, Sevilla, Spain.",
            "firstname": "Miguel \u00c1ngel",
            "initials": "M\u00c1",
            "lastname": "G\u00f3mez Bravo"
        },
        {
            "affiliation": "Virgen del Roc\u00edo University Hospital, Sevilla, Spain.",
            "firstname": "Jos\u00e9 Mar\u00eda",
            "initials": "JM",
            "lastname": "\u00c1lamo Mart\u00ednez"
        },
        {
            "affiliation": "Virgen del Roc\u00edo University Hospital, Sevilla, Spain.",
            "firstname": "Inmaculada",
            "initials": "I",
            "lastname": "Ben\u00edtez Linero"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2022 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.transproceed.2022.10.016",
    "journal": "Transplantation proceedings",
    "keywords": [],
    "methods": null,
    "publication_date": "2022-11-14",
    "pubmed_id": "36372564",
    "results": "Patients in group 1 (n\u00a0=\u00a0165, 79.9%) presented, with statistical significance, lower mortality at 1 month, 1 year, and 3 years; shorter duration of admission to the critical care unit and of hospital stay; lower incidence of surgical reoperation and retransplant; lower rate of transfusion of blood products; fewer pulmonary, digestive, neurologic, cardiologic, hemodynamic, kidney, surgical, infectious, metabolic, thrombotic, vascular, and graft complications; less need for kidney replacement therapy; less refractory ascites; and greater infectious risk. However, no statistically significant differences were found in the need for hospital readmission; in biliary, endocrine, nutritional, hematologic, thrombotic, and hematologic complications; or in graft rejection. In group 1, 6.6% of patients required reintubation. In group 2, 97% of patients could be extubated during the first week; 7.8% required noninvasive mechanical ventilation type bilevel positive airway pressure and 8.1% high flow. Only 2.8% of patients required tracheotomy.",
    "title": "Role of Early Extubation in Decreasing Morbidity and Mortality in Liver Transplantation.",
    "xml": "<Element 'PubmedArticle' at 0x7885067b8630>"
}