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All consenting, adult patients aged 18 years and above who will require elective ventilation after liver transplant recipient surgery will be enrolled for the study. Patients in acute liver failure, hepatic encephalopathy or patients with history of allergic reactions to propofol will be excluded from the study. This is an observational study. As per institute treatment protocol, propofol will be given post-operatively at a dose of 1 mg/kg/hr and than titrated to maintain a Bi-Spectral Index (BIS) score of 60-80 till the patient is on ventilator. There will be no deviation from our routine institutional protocol and no other sedative drugs like opioids or benzodiazepines will be used and no interventions will be done. Hemodynamics will be maintained targeting a mean arterial pressure (MAP) of at least 65 mm Hg. during the study period using appropriate measures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Liver transplant recipients | Adult patients requiring elective post-operative ventilation after a living donor liver transplant receiving intravenous propofol infusion for sedation titrated to Bi-Spectral Index (BIS) score of 60-80,as per our institutional protocol. |
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| Measure | Description | Time Frame |
|---|---|---|
| Dosage of propofol in mg/kg/hr required for sedation (BIS:60-80) of postoperative electively ventilated living donor liver transplant recipients. | Every 2 hrly , the continuous intravenous Propofol dose going on will be recorded. | up to 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Changes of propofol dose over the study period to maintain BIS between 60 -80 | Propofol doses will be recorded titrated to BIS of 60-80 | up to 24 hours |
| Correlation of the mean dose of propofol in mg/kg/hr with Arterial ammonia at baseline and to see the association between immediate post operative and Postoperative day1 ammonia with corresponding propofol dose. |
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Inclusion Criteria:
• Living donor liver transplant (LDLT) recipient adult patients ≥ 18 years of age requiring postoperative elective ventilation.
Exclusion Criteria:
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All consenting LDLT recipient adult patients ≥ 18 years of age who require postoperative elective ventilation after recieving a living donor liver transplant.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Rishabh jaju, DNB | Contact | 7742454477 | rishabh.cares@gmail.com | |
| Kelika Prakash, DM | Contact | 9540947117 | kelika.prakash@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| rishabh jaju, DNB | Institute of liver and biliary sciences,New Delhi-110070 | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute of liver and biliary sciences | Recruiting | New Delhi | National Capital Territory of Delhi | 110070 | India |
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Arterial ammonia levels will be noted pre-operatively, immediate post-operative and after extubation. |
| up to 24 hours |
| Correlation of propofol dose with respective arterial lactate levels every 2 hours during the period of elective ventilation | Lactate levels will be recorded every 2 hrs till the patient is on ventilator | up to 24 hours |