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PubMedDate not supplied

[The relation between the viscosity of enteral nutrition products and delays or interruptions in the infusion rate selected].

Enteral nutrition infusion systems block or suffer alterations to the infusion rate selected at the pump, creating significant problems in the clinic. The manufacturers insist on the important of not using fine-bore catheters when products are viscous, but they provide no specific data correlating bore with maximum advisable viscosity. Experimental work was carried out in order to relate these variable and fix a pattern for selection of nutrients according to their physical properties and a particular catheter bore. The results of our study indicate that none of the products currently of the market for enteral nutrition creates problems with the selected infusion rate, nor blocking of a probe of minimum bore (6 CH). Thus the complications attributed to catheter bore or the physical characteristics of a product are attributable to the poor preparation of the product or improper handling or care of catheters and infusion systems.

Catheterization, Peripheral↗

PubMedDate not supplied

Effects of intraoperative blood transfusion on postoperative complications and survival after orthotopic liver transplantation.

BACKGROUND/AIMS: Massive blood transfusion related to the coagulation disorders occurring during the anhepatic and reperfusion phases, remains a serious problem during orthotopic liver transplantation. To analyze the influence of intraoperative blood transfusion on postoperative complications, and survival and to identify the preoperative variables associated with greater intraoperative bleeding, 100 orthotopic liver transplantations, carried out on adults, were reviewed in our center. METHODOLOGY: Patients were grouped into three categories according to intraoperative blood volume transfused; group A, 1.5 or less blood volumes transfused; group B, > 1.5 and < 3 volumes used and group C, 3 or more volumes given. RESULTS: Group C patients had a higher incidence of upper abdominal surgery (p < 0.01 between groups C and A. and p<0.05 between groups C and B); higher values of postoperative total bilirubin and SGOT, and lower prothrombin activity. Acute rejection and steroid-resistant episodes per patient occurred less commonly (p <0.01 between groups C and A) and so did chronic rejection (p <0.05 between groups C and B). Higher infection rate, and gastrointestinal and intraabdominal complication rates were also noticed in groups C and B (p < 0.01 and p < 0.05 respectively). Patient survival rates were lower in group C (p < 0.05 between groups C and A). CONCLUSIONS: It was concluded that previous upper abdominal surgery was the only preoperative factor associated with massive blood transfusion. Poor graft function during the first days after transplant, higher incidence of infections, higher incidence of gastrointestinal and intraabdominal complications, and lower rejection episodes and survival for patients receiving intraoperatively large amounts of blood can be expected.

Adult↗