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19 February 2015 : Original article  

The Effectiveness of Prophylactic Attachment of Adhesive Defibrillation Pads in Adult Living Donor Liver Transplantation

Chih-Hsien WangABCDEF, Kwok-Wai ChengABD, Chao-Long ChenAB, Shoa-Chun WuBCD, Tsung-Hsiao ShihAB, Sheng-Chun YangAB, Bruno JawanABDE, Chia-Jung HuangABCDEF

DOI: 10.12659/AOT.892639

Ann Transplant 2015; 20:97-102

Abstract

BACKGROUND: The aim of current study is to present the effectiveness of prophylactic attachment of adhesive defibrillation electrode pads in adult living donor liver transplantation.

MATERIAL AND METHODS: We divided 487 adult living donor liver transplantation patients into 2 Eras according to the history of without (Era 1) and with (Era 2) pre-attachment of adhesive defibrillation pads. The incidences of intraoperative cardiac events requiring cardioversion or defibrillation, its management, and outcome between Era 1 and 2 were compared.

RESULTS: Two cases out of 124 patients (1.6%) in Era 1 had cardiac arrest. The closed chest cardiac massage in 1 cardiac arrest in Era 1 required trans-diaphragmatic open-chest cardiac massage followed by internal cardiac defibrillation due to difficulty in performing external defibrillation. Both patients of Era 1 had in-hospital mortality. Four patients of Era 2 (n=363) received electrical treatment (1.01%); 2 had paroxysmal tachycardia requiring cardio-version and the other 2 had ventricular fibrillation requiring closed-chest cardiac massage and external defibrillation. All 4 patients in Era 2 regained sinus rhythm after electrical treatment, tolerated the subsequent operation well, and had 100% survival to date.

CONCLUSIONS: Our results show that prophylactic attachment of adhesive defibrillation pads allows the immediate performance of cardioversion, conventional closed-chest CPR, and defibrillation if indicated without any delay and without interference with the sterility of the operation field. Our preliminary result is clear and encouraging.

Keywords: Advanced Cardiac Life Support, Anesthesia, Defibrillators, Liver Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358