Document Detail

Does thoracic epidural analgesia improve outcome after lung transplantation?
MedLine Citation:
PMID:  20937664     Owner:  NLM     Status:  In-Process    
A best evidence topic was constructed according to a structured protocol. The question addressed was whether the use of preoperative or early postoperative thoracic epidural analgesia (TEA) is effective in improving outcomes--reducing duration of mechanical ventilation, intensive care unit (ICU) length of stay and respiratory complications--in patients undergoing lung transplantation (LTx). Of the 42 papers found using a report search, five presented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. We conclude that, on the whole, four out of the five retrieved studies clearly supported the use of TEA as the cornerstone of a multi-faceted strategy for improving outcomes after LTx. Indeed, the interest and benefit was shown not only in terms of duration of mechanical ventilation, but also in reducing the ICU length of stay and the number of respiratory complications. Hence, current evidence suggests TEA to be safe and effective in alleviating postoperative pain and in improving patient recovery, thus enhancing the choice of available medical care and bettering outcome after LTx. However, given the low level of evidence of published studies, prospective trials are warranted to confirm those encouraging results.
Julien Pottecher; Pierre-Emmanuel Falcoz; Gilbert Massard; Jean-Pierre Dupeyron
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Publication Detail:
Type:  Journal Article     Date:  2010-10-11
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  12     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  51-3     Citation Subset:  IM    
Department of Anesthesiology and Critical Care Medicine, University Hospital, Strasbourg, France.
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