ODM+ as Part of Enhanced Recovery in Renal Transplantation
ODM+ is recommended by NICE for use as part of an Enhanced Recovery Programme(ERP) to safely guide fluid and vasoactive/inotropic drugs. A new study demonstrates its value in patients with inherent haemodynamic complexities. The study challenges the belief among renal transplant clinicians that the principles of ER would be difficult to implement in chronic renal failure patients undergoing transplantation.
The study (abstract here) looks at the outcomes when an ER programme is applied in renal transplantation. The study institution in Sheffield (UK) used Deltex ODM+ to guide fluid therapy as referenced by NICE and to reduce the use of central venous lines (apart from inotropic use).
286 patients were selected, with 135 in the ERP group and 151 in the traditional care group. Assessment included the quality of patient care and patient satisfaction.
Results showed statistically significant reductions in postoperative pain, length of stay (LOS) for living donors, LOS for recipients and costs in the ERP group as well as better patient satisfaction.
With 1-day hospital stay costing £513 in the NHS, reduction in LOS as a result of implementing ER saves £2052 per living-related transplant (4 days difference in the mean length of stay) and £2565 per deceased-donor transplant (5 days difference in the mean length of stay).
The authors conclude “Our service evaluation demonstrated that enhanced recovery benefits both types of renal transplant (living and deceased grafts) procedures, with excellent patient satisfaction and reduction of hospital length of stay”.
“We have to emphasize that ER does not only improve the quality of care of renal transplant patients but also provides other patients with advantages by reallocating the nursing and medical staff to look after critically ill patients in the current National Health Service environment of shortage of health care workers.”