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Factors Associated with Postoperative Prolonged Mechanical Ventilation in Pediatric Liver Transplant Recipients

Olubukola O Nafiu1,2, Katari Carello1,2, Anjana Lal1,2

  • 1Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA.

Anesthesiology Research and Practice
|August 1, 2017
PubMed

Insights

Prolonged postoperative mechanical ventilation (PPMV) affects approximately 25% of pediatric liver transplant recipients, particularly infants. Longer surgery duration is a key modifiable risk factor for PPMV, which is linked to worse outcomes.

Area of Science:

  • Pediatric Surgery
  • Transplant Medicine
  • Critical Care Medicine

Background:

  • Mechanical ventilation is common post-pediatric liver transplant (OLT).
  • Prolonged postoperative mechanical ventilation (PPMV) may indicate severe disease and impact outcomes.
  • Identifying PPMV risk factors is crucial for improving pediatric OLT care.

Purpose of the Study:

  • To determine the incidence of PPMV in pediatric OLT recipients.
  • To identify risk factors associated with PPMV in this population.

Main Methods:

  • Retrospective analysis of 128 pediatric OLT recipients.
  • PPMV defined as mechanical ventilation for ≥ 4 days post-surgery.
  • Multivariable logistic regression used to identify independent predictors.

Main Results:

  • An estimated 25% of pediatric OLT recipients experienced PPMV.
  • Incidence was highest in infants and associated with increased mortality.
  • Younger age, preoperative hypocalcemia, and longer surgery duration predicted PPMV.

Conclusions:

  • PPMV is common in pediatric OLT and linked to adverse outcomes.
  • Longer intensive care unit and hospital stays were observed with PPMV.
  • Increasing surgery duration is the sole modifiable predictor of PPMV.
Abstract

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