Cargando…

The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience

The objective of this study was to assess whether resident exposure to liver transplantation anesthesia results in improved patient care during a simulated critical care scenario. Our hypothesis was that anesthesia residents exposed to liver transplantation anesthesia care would be able to identify...

Descripción completa

Detalles Bibliográficos
Autores principales: Nguyen, Dung, Gurvitz-Gambrel, Shira, Sloan, Paul A., Dority, Jeremy S., DiLorenzo, Amy, Hassan, Zaki-Udin, Rebel, Annette
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The International College of Surgeons, World Federation of General Surgeons and Surgical Specialists, Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400937/
https://www.ncbi.nlm.nih.gov/pubmed/25875549
http://dx.doi.org/10.9738/INTSURG-D-14-00279.1
_version_ 1782367081775235072
author Nguyen, Dung
Gurvitz-Gambrel, Shira
Sloan, Paul A.
Dority, Jeremy S.
DiLorenzo, Amy
Hassan, Zaki-Udin
Rebel, Annette
author_facet Nguyen, Dung
Gurvitz-Gambrel, Shira
Sloan, Paul A.
Dority, Jeremy S.
DiLorenzo, Amy
Hassan, Zaki-Udin
Rebel, Annette
author_sort Nguyen, Dung
collection PubMed
description The objective of this study was to assess whether resident exposure to liver transplantation anesthesia results in improved patient care during a simulated critical care scenario. Our hypothesis was that anesthesia residents exposed to liver transplantation anesthesia care would be able to identify and treat a simulated hyperkalemic crisis after reperfusion more appropriately than residents who have not been involved in liver transplantation anesthesia care. Participation in liver transplantation anesthesia is not a mandatory component of the curriculum of anesthesiology training programs in the United States. It is unclear whether exposure to liver transplantation anesthesia is beneficial for skill set development. A high-fidelity human patient simulation scenario was developed. Times for administration of epinephrine, calcium chloride, and secondary hyperkalemia treatment were recorded. A total of 25 residents with similar training levels participated: 13 residents had previous liver transplantation experience (OLT), whereas 12 residents had not been previously exposed to liver transplantations (non-OLT). The OLT group performed better in recognizing and treating the hyperkalemic crisis than the non-OLT group. Pharmacologic therapy for hyperkalemia was given earlier (OLT 53.3 ± 27.0 seconds versus non-OLT 148 ± 104.1 seconds; P < 0.01) and hemodynamics restored quicker (OLT 87.9 ± 24.9 seconds versus non-OLT 219.9 ± 87.1 seconds; P < 0.01). Simulation-based assessment of clinical skills is a useful tool for evaluating anesthesia resident performance during an intraoperative crisis situation related to liver transplantations. Previous liver transplantation experience improves the anesthesia resident's ability to recognize and treat hyperkalemic cardiac arrest.
format Online
Article
Text
id pubmed-4400937
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher The International College of Surgeons, World Federation of General Surgeons and Surgical Specialists, Inc.
record_format MEDLINE/PubMed
spelling pubmed-44009372016-04-01 The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience Nguyen, Dung Gurvitz-Gambrel, Shira Sloan, Paul A. Dority, Jeremy S. DiLorenzo, Amy Hassan, Zaki-Udin Rebel, Annette Int Surg General Surgery & Principles of Surgery The objective of this study was to assess whether resident exposure to liver transplantation anesthesia results in improved patient care during a simulated critical care scenario. Our hypothesis was that anesthesia residents exposed to liver transplantation anesthesia care would be able to identify and treat a simulated hyperkalemic crisis after reperfusion more appropriately than residents who have not been involved in liver transplantation anesthesia care. Participation in liver transplantation anesthesia is not a mandatory component of the curriculum of anesthesiology training programs in the United States. It is unclear whether exposure to liver transplantation anesthesia is beneficial for skill set development. A high-fidelity human patient simulation scenario was developed. Times for administration of epinephrine, calcium chloride, and secondary hyperkalemia treatment were recorded. A total of 25 residents with similar training levels participated: 13 residents had previous liver transplantation experience (OLT), whereas 12 residents had not been previously exposed to liver transplantations (non-OLT). The OLT group performed better in recognizing and treating the hyperkalemic crisis than the non-OLT group. Pharmacologic therapy for hyperkalemia was given earlier (OLT 53.3 ± 27.0 seconds versus non-OLT 148 ± 104.1 seconds; P < 0.01) and hemodynamics restored quicker (OLT 87.9 ± 24.9 seconds versus non-OLT 219.9 ± 87.1 seconds; P < 0.01). Simulation-based assessment of clinical skills is a useful tool for evaluating anesthesia resident performance during an intraoperative crisis situation related to liver transplantations. Previous liver transplantation experience improves the anesthesia resident's ability to recognize and treat hyperkalemic cardiac arrest. The International College of Surgeons, World Federation of General Surgeons and Surgical Specialists, Inc. 2015-04 /pmc/articles/PMC4400937/ /pubmed/25875549 http://dx.doi.org/10.9738/INTSURG-D-14-00279.1 Text en © 2015 Nguyen et al. http://creativecommons.org/licenses/by-nc/3.0 licensee The International College of Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non-commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0
spellingShingle General Surgery & Principles of Surgery
Nguyen, Dung
Gurvitz-Gambrel, Shira
Sloan, Paul A.
Dority, Jeremy S.
DiLorenzo, Amy
Hassan, Zaki-Udin
Rebel, Annette
The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience
title The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience
title_full The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience
title_fullStr The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience
title_full_unstemmed The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience
title_short The Impact of Exposure to Liver Transplantation Anesthesia on the Ability to Treat Intraoperative Hyperkalemia: A Simulation Experience
title_sort impact of exposure to liver transplantation anesthesia on the ability to treat intraoperative hyperkalemia: a simulation experience
topic General Surgery & Principles of Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400937/
https://www.ncbi.nlm.nih.gov/pubmed/25875549
http://dx.doi.org/10.9738/INTSURG-D-14-00279.1
work_keys_str_mv AT nguyendung theimpactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT gurvitzgambrelshira theimpactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT sloanpaula theimpactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT dorityjeremys theimpactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT dilorenzoamy theimpactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT hassanzakiudin theimpactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT rebelannette theimpactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT nguyendung impactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT gurvitzgambrelshira impactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT sloanpaula impactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT dorityjeremys impactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT dilorenzoamy impactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT hassanzakiudin impactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience
AT rebelannette impactofexposuretolivertransplantationanesthesiaontheabilitytotreatintraoperativehyperkalemiaasimulationexperience