EXPORT CITATION

Chapter-40 Critical Care Considerations in the Management of Renal Transplant Patients

BOOK TITLE: Kidney & Pancreas Transplantation

Author
1. Nicastro Jeffrey M.
2. Barnett Richard
3. Pasmantier RoseMarie
4. Alex Asha
5. Singh Narendra
ISBN
9789351523390
DOI
10.5005/jp/books/12547_41
Edition
1/e
Publishing Year
2015
Pages
8
Author Affiliations
1. Hofstra North Shore – LIJ School of Medicine and North Shore – Long Island Jewish Health System, New York, USA
2. North Shore-LIJ Health System; Hofstra North Shore-LIJ School of Medicine, Hempstead, New York, USA
3. Veterans Affairs New Jersey Healthcare System, East Orange, New Jersey, USA
4. North Shore-LIJ Health System, Hempstead, New York, USA
5. North Shore-LIJ Health System, Hempstead, New York, USA
Chapter keywords
adult renal transplant, emergency department, respiratory alkalosis, hemodynamic instability, hypertension, uncontrolled hyperglycemia, hemorrhage, respiratory failure, hypotension, renal failure, infections, metabolic abnormalities, nasal cannula

Abstract

This chapter discusses about the management of adult renal transplant patients in emergency department, PACU, MICU, SICU, and CCU, where focus on issues such as patient selection, nature of the surgery, and adverse consequences of immunosuppression should be given. Immediate PACU postoperative considerations or limiting factors include persistent respiratory compromise, respiratory alkalosis, hemodynamic instability, cardiovascular problems, severe hypertension, and uncontrolled hyperglycemia. Delayed metabolism of anesthetics and sedatives in these patients with renal insufficiency may result in prolonged respiratory and cognitive depression. Noninvasive positive pressure ventilation in extubated patients may be required before transition to supplemental oxygen either by mask or nasal cannula. Ultrafiltration is an additional option but requirement for continuous IV administration of antihypertensive agents is best accomplished in the critical care setting. Postoperative considerations the ICU include hemorrhage, respiratory failure, hypotension, renal failure, infections, and metabolic abnormalities.

Related Books

© 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved