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Anesthesiology Research and Practice
Volume 2017 (2017), Article ID 3728289, 8 pages
Research Article

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

1Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
2Section of Pediatric Anesthesiology, University of Michigan, Ann Arbor, MI, USA
3Department of Surgery, University of Michigan, Ann Arbor, MI, USA

Correspondence should be addressed to Olubukola O. Nafiu

Received 10 March 2017; Accepted 18 May 2017; Published 3 July 2017

Academic Editor: Michael Frass

Copyright © 2017 Olubukola O. Nafiu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Almost all pediatric orthotopic liver transplant (OLT) recipients require mechanical ventilation in the early postoperative period. Prolonged postoperative mechanical ventilation (PPMV) may be a marker of severe disease and may be associated with morbidity and mortality. We determined the incidence and risk factors for PPMV in children who underwent OLT. Methods. This was a retrospective analysis of data collected on 128 pediatric OLT recipients. PPMV was defined as postoperative ventilation ≥ 4 days. Perioperative characteristics were compared between cases and control groups. Multivariable logistic regression analysis was used to calculate odds ratios for PPMV after controlling for relevant cofactors. Results. An estimated 25% (95% CI, 17.4%–32.6%) required PPMV. The overall incidence of PPMV varied significantly by age group with the highest incidence among infants. PPMV was associated with higher postoperative mortality () and longer intensive care unit () and hospital length of stay (). Multivariable analysis identified young patient age, preoperative hypocalcemia, and increasing duration of surgery as independent predictors of PPMV following OLT. Conclusion. The incidence of PPMV is high and it was associated with prolonged ICU and hospital LOS and higher posttransplant mortality. Surgery duration appears to be the only modifiable predictor of PPMV.