Correlation Between Functional Capacity and Respiratory Assessment of End-Stage Liver Disease Patients Waiting for Transplant

Santos, Daniele Costa dos; Limongi, Vivian; Silva, A.M.O. Da; Ataíde, Elaine Cristina de; Mei, M.F.T.; Udo, E.Y.; Boin, I.F.S.F.; Stucchi, R.S.B.

doi:10.1016/j.transproceed.2014.07.014

Cited by 14 publications

(12 citation statements)

References 19 publications

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“…Furthermore, majority of the patients belonged to low and middle income families and had to face many financial difficulties during their treatment process. The findings of Santos et al study showed that, patients waiting for liver transplantation are affected by complications such as muscle weakness, and physical limitations, which increase the mortality rate significantly (19). Furthermore, results of numerous studies on patients waiting for heart, lungs, kidneys, and liver transplants showed that, patients experience multiple physical complications, including energy reduction, physical limitation, and exacerbation of disease and its complications (13,20).…”

Section: Discussionmentioning

confidence: 99%

Life Experiences of Hepatitis Patients Waiting for Liver Transplantation

et al. 2017

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Background: Since the number of hepatitis patients requiring liver transplantation is on the rise and the waiting list for such operation is long, the quality of life of these patients will be affected. Providing any care and health services requires an understanding of these patients' real experience and their specific needs. Objectives: Therefore, this study aimed to explore the life experiences of hepatitis patients waiting for liver transplantation. Methods: This was a qualitative study with content analysis approach. Participants in this study consisted of 10 hepatitis patients on the waiting list for liver transplantation, who were selected through purposive sampling. For data collection, semi-structured interviews were conducted and data were analyzed using Landman and Grantham and constant comparison methods. Results: The participants included 10 hepatitis patients with a mean age of 41.4 years, and 34.8 months average time being on the waiting list. The main themes of "life turmoil (being troubled for the family and living with hardship), "searching" (searching for information and search for a change in treatment approach), spirituality (trust and faith in God and relaying on Imams (Tavasol)), and "new concerns" (unhappiness in life and challenge and consequence of waiting) were extracted from the data. Conclusions: Hepatitis patients' experiences included family economic problems, exacerbation of the disease and its complications, lack of adherence to treatment regimen, and physical and psychosocial problems. Knowing and understanding the issues and problems of these patients can create positive changes in their time when waiting for liver transplantation, and can empower them in this difficult time so they can have a more successful transplantation.

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Section: Discussionmentioning

confidence: 99%

Life Experiences of Hepatitis Patients Waiting for Liver Transplantation

et al. 2017

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“…(13) Additionally, markers of patient function, including the 6-minute walk test, (14) evaluation of maximum inspiratory pressure and maximum expiratory pressure using manometry, and surface electromyography of the diaphragm and rectus abdominis muscles, have shown that patients with cirrhosis have increased respiratory muscle weakness compared to controls. (15,16) From this literature, measurements of weakness and decreased muscle strength in pre-LT patients may be predictive of adverse outcomes. Therefore, our data may suggest that PFTs may be more of a noninvasive means of identifying how much these weakness parameters are affecting lung function in the preoperative assessment rather than simply the result of ascites and obesity.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, measures of frailty, such as activities of daily living, the Braden Scale, and the Morse fall risk score (standardized measures of frailty), have been found to be predictive of 90‐day mortality, LOS, and need for rehabilitation for hospitalized patients with cirrhosis . Additionally, markers of patient function, including the 6‐minute walk test, evaluation of maximum inspiratory pressure and maximum expiratory pressure using manometry, and surface electromyography of the diaphragm and rectus abdominis muscles, have shown that patients with cirrhosis have increased respiratory muscle weakness compared to controls . From this literature, measurements of weakness and decreased muscle strength in pre‐LT patients may be predictive of adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

The utility of pulmonary function testing in predicting outcomes following liver transplantation

Kia

Cuttica²,

Yang

et al. 2016

Liver Transpl

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Although pulmonary function tests (PFTs) are routinely performed in patients during the evaluation period before liver transplantation (LT), their utility in predicting post-LT mortality and morbidity outcomes is not known. The aim of this study was to determine the impact of obstructive and/or restrictive lung disease on post-LT outcomes. We conducted a retrospective analysis of patients who had pre-LT PFTs and underwent a subsequent LT (2007LT ( -2013. We used statistical analyses to determine independent associations between PFT parameters and outcomes (graft/patient survival, time on ventilator, and hospital/intensive care unit [ICU] length of stay [LOS]). A total of 415 LT recipients with available PFT data were included: 65% of patients had normal PFTs; 8% had obstructive lung disease; and 27% had restrictive lung disease. There was no difference in patient and graft survival between patients with normal, obstructive, and restrictive lung disease. However, restrictive lung disease was associated with longer post-LT time on ventilator and both ICU and hospital LOS (P < 0.05). More specific PFT parameters (diffusing capacity of the lungs for carbon monoxide, total lung capacity, and residual volume) were all significant predictors of ventilator time and both ICU and hospital LOS (P < 0.05). Postoperative pulmonary complications following liver transplantation (LT) are common and have been associated with increased morbidity and mortality. Infectious complications, prolonged ventilator time, need for reintubation, atelectasis, pleural effusions, acute respiratory distress syndrome, and pulmonary edema have been identified as the main pulmonary complications following LT.(1,2) Both preoperative and intraoperative variables are thought to play a role in the development of pulmonary complications, and although there have been significant advances in critical care and hemodynamic monitoring of LT recipients, pulmonary complications continue to be a significant problem.Studies have identified pre-LT risk factors for postoperative pulmonary complications, including age, (3) severity of liver dysfunction, (4)(5)(6) perioperative fluid administration, smoking history, (7) female sex,and preexisting diabetes. (8,9) Few studies have evaluated preexisting pulmonary dysfunction as a risk factor for Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; CT, computed tomography; DLCO, diffusing capacity of the lungs for carbon monoxide; ESLD, end-stage liver disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; ICU, intensive care unit; IQR, interquartile range; LOS, length of stay; LT, liver transplantation; MELD, Model for End-Stage Liver Disease; OR, odds ratio; PFT, pulmonary function test; RV, residual volume; SD, standard deviation; TLC, total lung capacity.Address reprint requests to Josh Levitsky, M.D., M.S.,

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“…18 In contrast, respiratory muscle strength can be assessed by measuring maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) through manovacuometry. 21 Compared to healthy patients, patients with liver disease exhibit a decreased MIP and MEP, denoting decreased muscle strength, which may be impacted by the presence of ascites with implications for increased duration on mechanical ventilation, postoperatively.…”

Section: Respiratory Muscle Profilingmentioning

confidence: 99%

“…23 Although its primary indication typically revolves around studying the response of medical therapy in moderate to severe heart and lung disease, it has been recently used in determining the functional capacity of patients with liver disease and as a predictor of mortality in liver transplant candidates. 20,21,[24][25][26] Compared to healthy patients, patients with liver disease typically exhibited a shorter distance walked which was also related to the severity of liver disease. 26 This distance walked is correlated with MIP and MEP.…”

Section: Functional Capacity Testingmentioning

confidence: 99%

Intensive Care of Pulmonary Complications Following Liver Transplantation

Lui

Spaho

Holzwanger

et al. 2018

J Intensive Care Med

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Chronic liver disease has been associated with pulmonary dysfunction both before and after liver transplantation. Post-liver transplantation pulmonary complications can affect both morbidity and mortality often necessitating intensive care during the immediate postoperative period. The major pulmonary complications include pneumonia, pleural effusions, pulmonary edema, and atelectasis. Poor clinical outcomes have been known to be associated with age, severity of liver dysfunction, and preexisting lung disease as well as perioperative events related to fluid balance, particularly transfusion and fluid volumes. Delineating each and every one of these pulmonary complications and their associated risk factors becomes paramount in guiding specific therapeutic strategies.

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Correlation Between Functional Capacity and Respiratory Assessment of End-Stage Liver Disease Patients Waiting for Transplant

Cited by 14 publications

References 19 publications

Life Experiences of Hepatitis Patients Waiting for Liver Transplantation

Life Experiences of Hepatitis Patients Waiting for Liver Transplantation

The utility of pulmonary function testing in predicting outcomes following liver transplantation

Intensive Care of Pulmonary Complications Following Liver Transplantation

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