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Methods compared baseline (Oct 2018-Sep 2020) versus an early extubation pathway implemented in Oct 2020 (Oct 2020-Sep 2022).",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/early-extubation-in-low-risk-liver-transplant-recipients-a-quality-improvement-project/449702/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/early-extubation-in-low-risk-liver-transplant-recipients-a-quality-improvement-project/449702.png","ImageObject",300,407,{"name":42,"@type":43},"RuangKosong","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",5,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the main goal of the quality improvement project?","Question",{"text":63,"@type":64},"To identify and extubate suitable low-risk liver transplant recipients within 4 hours after surgery.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the intervention implemented?",{"text":68,"@type":64},"An early extubation pathway was introduced in October 2020, with prospective data collected from October 2020 to September 2022.",{"name":70,"@type":61,"acceptedAnswer":71},"What outcomes improved after adopting the early extubation pathway?",{"text":72,"@type":64},"Extubation within 4 hours increased, and adjusted analyses showed reductions in mechanical ventilation duration, ICU length of stay, and hospital length of stay.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},449702,1791094591,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":55,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":106,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},962090883219,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Open access Quality improvement report  \n Early extubation in low-risk liver  \ntransplant recipients: a quality improvement project  \nKristen M Kidson  ,1,2 Allana LeBlanc,3 Steven Moore,1 Allison Chiu,4 Stéphanie Chartier-Plante5  \nTo cite: Kidson KM, LeBlanc A, Moore S, et al. Early extubation in low-risk liver transplant recipients:  \na quality improvement project. BMJ Open Quality 2026;15:e003556 . doi:10 . 1136/ bmjoq-2025-003556  \n► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjoq-2025-003556](bmjoq-2025-003556)) .  \nReceived 3 June 2025  \nAccepted 18 December 2025  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \n1Department of Anesthesia, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada  \n2Divison of Critical Care, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada 3Intensive Care Unit, Vancouver General Hospital, Vancouver, British Columbia, Canada 4Physician Led Quality Improvement, Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada 5Department of Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada  \nCorrespondence to  \nDr Kristen M Kidson; [kristen.kidson@vch.ca](kristen.kidson@vch.ca)  \nABSTRACT  \nBackground Increasing evidence supports early extubation in liver transplant (LT) recipients and the early recovery after surgery for LT guideline strongly recommends considering early extubation. Usual careat our institution involves admitting all LT recipients to the intensive care unit (ICU), sedated, mechanically ventilated and extubated during daytime hours. This quality improvement project aimed to identify and extubate suitable LT recipients within 4 hours postoperatively. Methods Baseline data were collected from all LT recipients between October 2018 and September 2020, the control group. An early extubation pathway was implemented in October 2020, and prospective data were collected from October 2020 to September 2022 and used as the intervention group. Primary outcome was extubation within 4 hours after LT. Secondary outcomes included the duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS.  \nMain results During the study period, 342 LT procedures were performed, of which 339 patients were included in the study. Of LT recipients who met criteria for  \nearly extubation, the rate of extubation within 4 hours postoperatively increased from 23%(14/60) in the control group to 65%(62/96) in the intervention group (p\u003C0 .001) . In adjusted models, the pathway was associated with an increased proportion of patients extubated within 4 hours (OR=6 .74, 95% CI 3.04 to 14 .92, p\u003C0 .001) and reduction in duration of mechanical ventilation (HR=1 .95, 95% CI 1.37 to 2 .79, p\u003C0 .001), ICU LOS (HR=1 .42, 95% CI 1.02 to 1.99, p=0 .04) and hospital LOS (HR=1 .60, 95% CI 1.14 to 2.26, p=0 .007) .  \nConclusions An early extubation pathway for LT recipients reduced duration of mechanical ventilation, ICU LOS and hospital LOS.  \nINTRODUCTION  \nLiver transplantation recipient mortality and morbidity have decreased owing to advancesin surgical techniques, perioperative care and immunosuppression. This improvement has led to a paradigm shift in post-transplant care, with a focus on facilitating early extubation. The potential benefits of early extubation include a reduction in mortality, shorter duration of mechanical ventilation, less vasopressor use, reduction in acute kidney injury and the need for renal replacement therapy,  \nWHAT IS ALREADY KNOWN ON THIS TOPIC  \n\n| ⇒ Evidence supports early extubation in liver transplant (LT) recipients. However, the adoption of early extubation in LT has been hindered by a lack of standardised protoco","cbCaigVhLHegiW8j","https://ap.wps.com/l/cbCaigVhLHegiW8j","pdf",529941,"English","# Abstract\n# Introduction\n# What is already known on this topic\n# What this study adds\n# How this study might affect research, practice or policy","[{\"question\":\"What was the main goal of the quality improvement project?\",\"answer\":\"To identify and extubate suitable low-risk liver transplant recipients within 4 hours after surgery.\"},{\"question\":\"How was the intervention implemented?\",\"answer\":\"An early extubation pathway was introduced in October 2020, with prospective data collected from October 2020 to September 2022.\"},{\"question\":\"What outcomes improved after adopting the early extubation pathway?\",\"answer\":\"Extubation within 4 hours increased, and adjusted analyses showed reductions in mechanical ventilation duration, ICU length of stay, and hospital length of stay.\"}]","Early extubation in low-risk liver transplant recipients - a quality improvement project | PDF",1790730930,18]