The effect of taurine supplementation on delirium post liver transplantation: A randomized controlled trial

Mottaghi, Shaghayegh; Nikoupour, Hamed; Firoozifar, Mohammad; Jalali, Seyed Soroush; Jamshidzade, Akram; Vazin, Afsaneh; Shafiekhani, Mojtaba

doi:10.1016/j.clnu.2022.07.042

Cited by 5 publications

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Delirium is a cognitive disorder that occurs in a short time and involves changes in attention, consciousness, orientation, memory, and perception (1). There are high incidence of postoperative delirium in liver transplant (LT) recipients, ranging from 7.5 to 47% (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Delirium in liver transplant recipients is often associated with metabolic disorders, infection, organ failure, hepatic or uremic encephalopathy, and admission to an intensive care unit (ICU), as well as the neurotoxic side effects from the use of immunosuppressive drugs such as calcineurin inhibitors or high-dose steroids (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

The influence of delirium on mortality and length of ICU stay and analysis of risk factors for delirium after liver transplantation

Ma,

Li,

Peng

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

ObjectiveTo analyze the incidence, timing, risk factors and prognosis of delirium after liver transplantation (LT).MethodsThe clinical data of 321 patients undergoing LT in the Third Xiangya Hospital of Central South University from January 2018 to December 2022 were collected to investigate the incidence, onset, and risk factors for post-LT delirium and the impact of delirium on LT recipients’ prognosis by statistical analysis.ResultsThe incidence of post-LT delirium was 19.3% (62/321), and the median interval between LT and onset of delirium was 20.1 h. Univariate analysis showed that pre-LT variables (Model for End Stage Liver Disease (MELD) score, hospital stay, hepatic encephalopathy, infection, white blood cell (WBC) count, lymphocyte count, abnormal potassium, lactulose use), intraoperative variables (red blood cell transfusion, remimazolam use, dexmedetomidine use) and post-LT variables (hypernatraemia, acute rejection, reoperation, basiliximab use, tacrolimus concentration) were associated with post-LT delirium. Multivariate logistic regression analysis revealed that MELD score at LT ≥22 [OR = 3.400, 95% CI:1.468–7.876, p = 0.004], pre-LT hepatic encephalopathy [OR = 3.224, 95% CI:1.664–6.244, p = 0.001], infection within 2 months prior to LT [OR = 2.238, 95% CI:1.151–4.351, p = 0.018], acute rejection [OR = 2.974, 95% CI:1.322–6.690, p = 0.008], and reoperation [OR = 11.919, 95% CI:2.938–48.350, p = 0.001] were independent risk factors for post-LT delirium. Post-LT delirium was reduced in LT recipients exposing to intraoperative remimazolam [OR = 0.287, 95% CI: 0.113–0.733, p = 0.009] or ≥ 25 μg of intraoperative dexmedetomidine [OR = 0.441, 95% CI 0.225–0.867, p = 0.018]. As for clinical outcomes, patients with delirium had a higher percentage of staying at the (ICU) ≥7 d after LT than those without delirium [OR = 2.559, 95% CI 1.418–4.617, p = 0.002].ConclusionThe incidence of delirium was high and the onset of delirium was early after LT. Risk factors for post-LT delirium included high MELD score at LT, pre-LT hepatic encephalopathy and infections, acute rejection and reoperation. Intraoperative use of remimazolam or dexmedetomidine reduced post-LT delirium. Delirium had a negative impact on the length of ICU stay.

show abstract

Section: Introductionmentioning

confidence: 99%

The influence of delirium on mortality and length of ICU stay and analysis of risk factors for delirium after liver transplantation

Ma,

Li,

Peng

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

show abstract

Perioperative taurine or taurolidine supplementation on clinical outcomes: A systematic review with meta-analysis

Ho,

Harahsheh

2024

APS

View full text Add to dashboard Cite

Taurine is a conditionally essential amino acid that has been reported to have antioxidative and immunomodulatory effects either directly or through its interactions with gut microbiome. Although taurine has been widely used as a health supplement and also for treatment of congestive heart failure in Japan, its roles in the perioperative setting have not been well characterized. The purpose of this systematic review and meta-analysis was to assess whether oral or intravenous taurine, or its derivatives such as taurolidine, can offer benefits compared to placebo in the perioperative setting. Non-randomized studies, trials assessed topical taurine or taurolidine, or trials did not report clinical outcomes were excluded. Six randomized-controlled-trials (RCTs) involving a total of 596 adult surgical patients, in PubMed, MEDLINE and EMBASE databases on September 14, 2023 were identified and meta-analyzed using a fixed-effect model. Biases were assessed by reporting individual trial elements. Taurine or taurolidine (which is readily metabolized by hydrolysis to taurine) supplementation was associated with a reduction in all-cause infection (5 trials: pooled odds ratio (OR) 0.59; 95% confidence interval (CI) 0.38–0.92; p = 0.020) but not delirium (2 trials: OR 0.63, 95% CI 0.38–1.04; p = 0.071) or mortality (4 trials: OR 0.82, 95% CI 0.43–1.58; p = 0.557) compared to placebo. Using the ‘trim and fill’ technique to adjust for publication bias did not change the favorable effect of taurine on risk of infection (OR 0.61, 95% CI 0.40–0.95). Because the number of studies included was small, the promising benefits of taurine on risks of perioperative infection should be confirmed by adequately-powered RCTs.

show abstract

Characteristics associated with effectiveness in postoperative delirium research: a systematic review of randomised controlled trials with meta-regression and meta-analysis

Meng,

Zhao,

Sun

et al. 2024

British Journal of Anaesthesia

View full text Add to dashboard Cite

The effect of taurine supplementation on delirium post liver transplantation: A randomized controlled trial

Cited by 5 publications

References 28 publications

The influence of delirium on mortality and length of ICU stay and analysis of risk factors for delirium after liver transplantation

The influence of delirium on mortality and length of ICU stay and analysis of risk factors for delirium after liver transplantation

Perioperative taurine or taurolidine supplementation on clinical outcomes: A systematic review with meta-analysis

Characteristics associated with effectiveness in postoperative delirium research: a systematic review of randomised controlled trials with meta-regression and meta-analysis

Contact Info

Product

Resources

About