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KMID : 0356920130650030228
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Korean Journal of Anesthesiology
2013 Volume.65 No. 3 p.228 ~ p.236
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Perioperative risk factors for prolonged mechanical ventilation after liver transplantation due to acute liver failure
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Lee Se-Rin
Jung Hyun-Sik
Choi Jong-Ho
Lee Jae-Min
Hong Sang-Hyun
Lee Sung-Hyun
Park Chul-Soo
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Abstract
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Background: Acute liver failure (ALF) is a rapidly progressing and fatal disease for which liver transplantation (LT) is the only treatment. Posttransplant mechanical ventilation tends to be more prolonged in patients with ALF than in other LT patients. The present study examined the clinical effects of prolonged posttransplant mechanical ventilation (PMV), and identified risk factors for PMV following LT for ALF. Methods: We reviewed data of patients undergoing LT for ALF between January 2005 and June 2011. After grouping patients according to administration of PMV (≥ 24 h), donor and recipient perioperative variables were compared between the groups with and without PMV. Potentially significant factors (P < 0.1) from the univariate intergroup comparison were entered into a multivariate logistic regression to establish a predictive model for PMV. Results: We reviewed data of patients undergoing LT for ALF between January 2005 and June 2011. After grouping patients according to administration of PMV (≥ 24 h), donor and recipient perioperative variables were compared between the groups with and without PMV. Potentially significant factors (P < 0.1) from the univariate intergroup comparison were entered into a multivariate logistic regression to establish a predictive model for PMV. Conclusions: PMV was associated with deleterious outcomes. Besides care for known risk factors including hepatic encephalopathy, meticulous attention to managing intraoperative hemodynamic circulatory status is required to avoid PMV and improve the posttransplant prognosis in ALF patients.
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KEYWORD
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Acute liver failure, Liver transplantation, Mechanical ventilation, Prediction
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