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Article ; Online: Role of Early Extubation in Decreasing Morbidity and Mortality in Liver Transplantation.

Arnal García, Sonia / Fernández Castellano, Guiomar / Bastón Castiñeiras, Minia / Gómez Bravo, Miguel Ángel / Álamo Martínez, José María / Benítez Linero, Inmaculada

Transplantation proceedings

2022

Abstract: Background: 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 ... ...

Abstract	Background: 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. Methods: A 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. Results: Patients in group 1 (n = 165, 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. Conclusions: The 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.
Language	English
Publishing date	2022-11-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2022.10.016
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Article ; Online: Impact of the Acute and Chronic Liver Failure-Sequential Evaluation of Organ Failure Scoring System on the Prognosis of Liver Transplant.

Pueyo-Périz, Eva María / Fernández-Castellano, Guiomar / García, Sonia Arnal / Romero, Juan Luis López / Bravo, Miguel Ángel Gómez / Benítez-Linero, Inmaculada

Transplantation proceedings

2022

Abstract: Background: The use of the Model of End-Stage Liver Disease (MELD) to predict morbidity and mortality after orthotopic liver transplant (OLT) is controversial. Acute and chronic liver failure-sequential evaluation of organ failure (CLIF-SOFA) is a new ... ...

Abstract	Background: The use of the Model of End-Stage Liver Disease (MELD) to predict morbidity and mortality after orthotopic liver transplant (OLT) is controversial. Acute and chronic liver failure-sequential evaluation of organ failure (CLIF-SOFA) is a new score that assess the patient's global status and that have been developed exclusively for patients with end-stage liver disease. The objective is to evaluate whether the CLIF-SOFA system predicts postoperative morbidity and mortality in the short and medium term. Methods: A cohort of 123 patients who underwent OLT in a tertiary care hospital between January 2016 and December 2017 was retrospectively analyzed. The patients were divided into 2 groups: group 1 with a CLIF-SOFA score <7 and group 2 with a score CLIF-SOFA ≥7. Results: Patients with a CLIF-SOFA ≥7 present, with statistical significance, had higher mortality at 1 and 3 years; longer duration of admission to the critical care unit; longer hospital stay; need for prolonged mechanical ventilation; surgical reintervention; higher rate of transfusion of blood products; pulmonary, neurologic, hemodynamic, surgical, infectious, kidney, metabolic, thrombotic, vascular, and graft complications; and need for kidney replacement therapy. However, no statistically significant differences were found in mortality in the first month, the need for hospital readmission, retransplant, digestive, endocrine, nutritional, hematologic, or biliary complications, and the presence of ascites. Conclusions: The role of CLIF-SOFA as a prognostic factor for mortality after OLT must be taken into account. Our results should be taken with caution, and more studies are necessary.
Language	English
Publishing date	2022-11-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2022.10.013
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Article ; Online: Hepatic Artery Thrombosis After Orthotopic Liver Transplant: Experience in the Last 10 Years.

Bastón Castiñeiras, Minia / Benítez Linero, Inmaculada / Serrano Zarcero, Virginia / Fernández Castellano, Guiomar / Suárez-Artacho, Gonzalo / López Romero, Juan Luis

Transplantation proceedings

2021 Volume 54, Issue 1, Page(s) 51–53

Abstract: Background: Hepatic artery thrombosis (HAT) is the second cause of graft failure, after primary disfunction. It has a significant morbidity, with a retransplant and mortality rate in early hepatic artery thrombosis of 50%. The incidence of this event ... ...

Abstract	Background: Hepatic artery thrombosis (HAT) is the second cause of graft failure, after primary disfunction. It has a significant morbidity, with a retransplant and mortality rate in early hepatic artery thrombosis of 50%. The incidence of this event goes from 2% to 9% in the adult population. Methods: The objective is to assess the incidence of HAT in a third-level hospital. The study design is an observational retrospective study, collecting data of the transplant recipient from 2010 to 2020. Results: Incidence of HAT was 5.33% (39/732). A statistical difference was found with the blood intraoperative administration (P = .002) and with the presence of anatomic abnormalities in the hepatic artery between the HAT and the non-HAT group. We did not find any statistical difference with portal thrombosis (P = .73) between the groups. Conclusions: HAT is a fatal complication after an orthotopic liver transplant, which can lead to graft loss and even recipient death. For these reasons, we should early identify risk factors associated with this event early and try to minimize them to avoid the devastating consequences.
MeSH term(s)	Adult ; Hepatic Artery ; Humans ; Liver Diseases ; Liver Transplantation/adverse effects ; Retrospective Studies ; Risk Factors ; Thrombosis/epidemiology ; Thrombosis/etiology
Language	English
Publishing date	2021-12-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.11.006
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Article ; Online: Case Report of a Patient Treated With Acenocumarol Awaiting Orthotopic Liver Transplant: Perioperative Coagulation Management and Risk for Hepatic Artery Thrombosis.

Serrano Zarcero, Virginia / Benítez Linero, Inmaculada / Bastón Castiñéiras, Minia / León Herrera, José / López Romero, Juan Luis

Transplantation proceedings

2021 Volume 54, Issue 1, Page(s) 62–64

Abstract: Background: End-stage liver disease is associated with a concomitant reduction of pro- and anticoagulant factors that typically leads to rebalanced hemostasis. This rebalanced hemostasis can be easily disturbed, encountering both hemostasis-related ... ...

Abstract	Background: End-stage liver disease is associated with a concomitant reduction of pro- and anticoagulant factors that typically leads to rebalanced hemostasis. This rebalanced hemostasis can be easily disturbed, encountering both hemostasis-related bleeding episodes and thrombotic events. Methods: This article reports a case of a 52-year-old man diagnosed with portal vein thrombosis and treated with Acenocumarol. The patient received ortothopic liver transplant. The preprocedure international normalized ratio was 3.5. A transfusion of 2000 units of prothrombin complex concentrate was indicated by Hematology. Results: Repeated intra- and postoperative hepatic artery thrombosis resulted in graft loss and patient retransplantation in first 24 hours. Conclusions: The new concept of rebalanced hemostasis in these patients forces us to change our clinical decisions in preoperative coagulation management, avoiding old practices based on the traditional model such as transfusion guided by international normalized ratio and platelet count, among others that will be analyzed in present work.
MeSH term(s)	Blood Coagulation ; Hepatic Artery/surgery ; Humans ; Liver Diseases ; Liver Transplantation/adverse effects ; Male ; Middle Aged ; Thrombosis/etiology
Language	English
Publishing date	2021-12-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.10.012
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Article ; Online: Cross-cultural adaptation, analysis of psychometric properties and validation of the Spanish version of a perioperative satisfaction questionnaire (EVAN-G).

Benítez-Linero, Inmaculada / Fernández-Castellano, Guiomar / Senent-Boza, Ana / Sánchez-Carrillo, Francisco / Docobo-Durantez, Fernando

Brazilian journal of anesthesiology (Elsevier)

2020 Volume 71, Issue 1, Page(s) 17–22

Abstract: Background: Patient satisfaction is a reliable and measurable indicator of the quality provided by a healthcare service. There are several questionnaires for measuring it, but only a few have shown good psychometric properties, an outstanding one being ... ...

Abstract	Background: Patient satisfaction is a reliable and measurable indicator of the quality provided by a healthcare service. There are several questionnaires for measuring it, but only a few have shown good psychometric properties, an outstanding one being the EVAN-G (Evaluation du Vécu de l'Anesthésie Générale) questionnaire, which measures patient satisfaction regarding perioperative care and is validated in French. The aim of this study is the validation of a Spanish version of the EVAN-G questionnaire. Methods: A translation/back-translation of the questionnaire into Spanish was carried out and the final version obtained was administered to three hundred patients. Its psychometric properties were measured and compared with those of the original EVAN-G questionnaire to verify that they had been maintained after the previous translation process. The questionnaire's content, construct and external validity were measured. To calculate reliability, Cronbach-α coefficient and test-retest method were used. The Global Satisfaction Index was calculated and satisfaction level in our sample was analyzed. Results: Content, construct and external validity were proven with similar results that in the original EVAN-G. The translated version of the questionnaire showed good reliability: Cronbach-α coefficient was 0.92 and intraclass correlation coefficient measured by test-retest method was 0.9. The acceptability was high. The average Global Satisfaction Index in our sample was 73±12. Conclusions: The translation into Spanish and cross-cultural adaptation of the EVAN-G questionnaire has proven its validity, reliability, and acceptability to measure patient satisfaction in interventions performed under general anesthesia.
MeSH term(s)	Cross-Cultural Comparison ; Humans ; Personal Satisfaction ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires ; Translations
Language	English
Publishing date	2020-12-25
Publishing country	Brazil
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2352-2291
ISSN (online)	2352-2291
DOI	10.1016/j.bjane.2020.07.011
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Article ; Online: Early implementation of protective measures defines surgical outcomes in the COVID-19 pandemic.

Senent-Boza, Ana / Benítez-Linero, Inmaculada / Tallón-Aguilar, Luis / Sánchez-Arteaga, Alejandro / Melero-Cortés, Lidia / Pareja-Ciuró, Felipe / Padillo-Ruiz, Javier

Surgery today

2020 Volume 50, Issue 9, Page(s) 1107–1112

Abstract: Quick implementation of specific protocols and protective measures in a tertiary hospital in Spain allowed for the early diagnosis and optimal management of patients with SARS-CoV-2 infection and proper protection of staff and inpatients. From the COVID- ... ...

Abstract	Quick implementation of specific protocols and protective measures in a tertiary hospital in Spain allowed for the early diagnosis and optimal management of patients with SARS-CoV-2 infection and proper protection of staff and inpatients. From the COVID-19 outbreak in this country until the time of writing, 14 patients in our hospital underwent surgery with COVID-19, or COVID-19 developed postoperatively. Their postoperative outcomes did not differ from those in our routine clinical practice, with a 0% respiratory failure rate and a 7.14% mortality rate, in contrast with other published series. COVID-19 did not develop in any of the healthcare workers present in the operating room during these procedures or in those who cared for these patients on the ward.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Clinical Protocols ; Cohort Studies ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Female ; Humans ; Infection Control/organization & administration ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Male ; Middle Aged ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; SARS-CoV-2 ; Spain ; Surgical Procedures, Operative ; Treatment Outcome
Keywords	covid19
Language	English
Publishing date	2020-07-22
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-020-02080-w
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Article ; Online: Manejo anestésico para cirurgia de atresia de esôfago em um recém-nascido com síndrome de Goldenhar.

Guerrero-Domínguez, Rosana / López-Herrera-Rodríguez, Daniel / Benítez-Linero, Inmaculada / Ontanilla, Antonio

Revista brasileira de anestesiologia

2015 Volume 65, Issue 4, Page(s) 298–301

Abstract: Background and objectives: Goldenhar's syndrome is a polymalformative condition consisting of a craniofacial dysostosis that determines difficult airway in up to 40% of cases. We described a case of a newborn with Goldenhar's syndrome with esophageal ... ...

Title translation	Anesthetic management for surgery of esophagus atresia in a newborn with Goldenhar's syndrome.
Abstract	Background and objectives: Goldenhar's syndrome is a polymalformative condition consisting of a craniofacial dysostosis that determines difficult airway in up to 40% of cases. We described a case of a newborn with Goldenhar's syndrome with esophageal atresia and tracheoesophageal fistula who underwent repair surgery. Case report: We report the case of a 24-hour-old newborn with Goldenhar's syndrome. He had esophageal atresia with distal tracheoesophageal fistula. It was decided that an emergency surgery would be performed for repairing it. It was carried out under sedation, intubation with fibrobronchoscope distal to the fistula, to limit the air flow into the esophagus, and possible abdominal distension. Following complete repair of the esophageal atresia and fistula ligation, the patient was transferred to the intensive care unit and intubated under sedation and analgesia. Conclusions: The finding of a patient with Goldenhar's syndrome and esophageal atresia assumes an exceptional situation and a challenge for anesthesiologists, since the anesthetic management depends on the patient comorbidity, the type of tracheoesophageal fistula, the usual hospital practice and the skills of the anesthesiologist in charge, with the main peculiarity being maintenance of adequate pulmonary ventilation in the presence of a communication between the airway and the esophagus. Intubation with fibrobronchoscope distal to the fistula deals with the management of a probably difficult airway and limits the passage of air to the esophagus through the fistula.
Language	Portuguese
Publishing date	2015-07
Publishing country	Brazil
Document type	English Abstract ; Journal Article
ZDB-ID	604154-1
ISSN	1806-907X ; 0034-7094
ISSN (online)	1806-907X
ISSN	0034-7094
DOI	10.1016/j.bjan.2013.07.011
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Article ; Online: Anesthetic management for surgery of esophagus atresia in a newborn with Goldenhar's syndrome.

Guerrero-Domínguez, Rosana / López-Herrera-Rodríguez, Daniel / Benítez-Linero, Inmaculada / Ontanilla, Antonio

Brazilian journal of anesthesiology (Elsevier)

2015 Volume 65, Issue 4, Page(s) 298–301

Abstract	Background and objectives: Goldenhar's syndrome is a polymalformative condition consisting of a craniofacial dysostosis that determines difficult airway in up to 40% of cases. We described a case of a newborn with Goldenhar's syndrome with esophageal atresia and tracheoesophageal fistula who underwent repair surgery. Case report: We report the case of a 24-h-old newborn with Goldenhar's syndrome. He had esophageal atresia with distal tracheoesophageal fistula. It was decided that an emergency surgery would be performed for repairing it. It was carried out under sedation, intubation with fibrobronchoscope distal to the fistula, to limit the air flow into the esophagus, and possible abdominal distension. Following complete repair of the esophageal atresia and fistula ligation, the patient was transferred to the intensive care unit and intubated under sedation and analgesia. Conclusions: The finding of a patient with Goldenhar's syndrome and esophageal atresia assumes an exceptional situation and a challenge for anesthesiologists, since the anesthetic management depends on the patient comorbidity, the type of tracheoesophageal fistula, the usual hospital practice and the skills of the anesthesiologist in charge, with the main peculiarity being maintenance of adequate pulmonary ventilation in the presence of a communication between the airway and the esophagus. Intubation with fibrobronchoscope distal to the fistula deals with the management of a probably difficult airway and limits the passage of air to the esophagus through the fistula.
MeSH term(s)	Airway Management/methods ; Anesthetics/administration & dosage ; Bronchoscopy/methods ; Clinical Competence ; Esophageal Atresia/etiology ; Esophageal Atresia/pathology ; Esophageal Atresia/surgery ; Goldenhar Syndrome/physiopathology ; Goldenhar Syndrome/surgery ; Humans ; Infant, Newborn ; Intubation, Intratracheal/methods ; Male ; Tracheoesophageal Fistula/etiology ; Tracheoesophageal Fistula/pathology ; Tracheoesophageal Fistula/surgery
Chemical Substances	Anesthetics
Language	English
Publishing date	2015-07
Publishing country	Brazil
Document type	Case Reports ; Journal Article
ZDB-ID	1142792-9
ISSN	0104-0014 ; 0104-0014
ISSN (online)	0104-0014
ISSN	0104-0014
DOI	10.1016/j.bjane.2013.07.011
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Article: Early implementation of protective measures defines surgical outcomes in the COVID-19 pandemic

Senent-Boza, Ana / Benítez-Linero, Inmaculada / Tallón-Aguilar, Luis / Sánchez-Arteaga, Alejandro / Melero-Cortés, Lidia / Pareja-Ciuró, Felipe / Padillo-Ruiz, Javier

Surg Today

Abstract	Quick implementation of specific protocols and protective measures in a tertiary hospital in Spain allowed for the early diagnosis and optimal management of patients with SARS-CoV-2 infection and proper protection of staff and inpatients. From the COVID-19 outbreak in this country until the time of writing, 14 patients in our hospital underwent surgery with COVID-19, or COVID-19 developed postoperatively. Their postoperative outcomes did not differ from those in our routine clinical practice, with a 0% respiratory failure rate and a 7.14% mortality rate, in contrast with other published series. COVID-19 did not develop in any of the healthcare workers present in the operating room during these procedures or in those who cared for these patients on the ward.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #662492
Database	COVID19

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Article ; Online: Early implementation of protective measures defines surgical outcomes in the COVID-19 pandemic

Senent-Boza, Ana / Benítez-Linero, Inmaculada / Tallón-Aguilar, Luis / Sánchez-Arteaga, Alejandro / Melero-Cortés, Lidia / Pareja-Ciuró, Felipe / Padillo-Ruiz, Javier

Surgery Today

2020 Volume 50, Issue 9, Page(s) 1107–1112

Keywords	Surgery ; General Medicine ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-020-02080-w
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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