Predictive factors for prolonged intubation following liver transplantation

This study identified risk factors associated with prolonged intubation after living donor liver transplantation (LDLT).

Out of 50 patients who underwent LDLT, clinical data were compared between those extubated within 4 days of LDLT (early group; n=20) and those extubated 5 days post-LDLT (delayed group; n=30).

Univariate analysis associated the following factors with prolonged intubation: preoperative age >48 years (p=0.05), body mass index >22 kg/m² (p=0.01), creatinine clearance <90 mL/min/1.73 m² (p=0.003), ratio between arterial oxygen tension and fractional inspired oxygen ≤375 (p=0.02) and postoperative changes of body-weight per body surface area ((BW - preoperative BW)/BSA)) on postoperative day (POD) 3 (>2.0 kg/m²) (p=0.01). Multivariate analysis showed that creatinine clearance and (BW - preoperative BW)/BSA on POD 3 remained as independent predictive factors (p=0.04 and 0.04, respectively).

We should aim for postoperative fluid management such that ((BW - preoperative BW)/BSA) ≤2.0 kg/m² on POD 3, especially in patients with low preoperative levels of creatinine clearance.