Risk factors of prolonged mechanical ventilation in pediatric post LT
Age, cirrhosis, and preoperative continuous renal replacement therapy are independent risk factors for prolonged mechanical ventilation (PMV) in children after liver transplantation (LT), according to a presentation at The Liver Meeting 2021.
A retrospective study included 195 patients (54% female) all under 18 years of age who received LT between 2014 and 2019 at a quaternary children’s hospital with a dedicated liver intensive care unit (ICU). Median age at LT was 45 months, 18% were < 1 year of age, 48% had cirrhosis, and 10% required continuous renal replacement therapy for acute kidney injury before LT. Incidence of PMV was 26%, and 7% required tracheostomy post-LT.
PMV was associated with prolonged ICU and hospital length of stay and lower 1-year post-LT survival. The researchers also found that cirrhotic cardiomyopathy was associated with PMV, and increased hospital ICU and hospital length of stay. Larger, multi-institutional prospective studies may be required to develop scores for prediction of PMV and to address modifiable risk factors for prevention of PMV after LT, they reported.
Mian MUM, et al. Age, cirrhosis and continuous renal replacement therapy are independent risk factors associated with prolonged mechanical ventilation in children after liver transplantation. Presented at American Association for the Study of Liver Diseases (AASLD) The Liver Meeting (TLM) 2021.