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EARLY TRACHEOSTOMY REDUCES TIME OF MECHANICAL VENTILATION IN RESPIRATORY HIGH-RISK PATIENTS AFTER LIVER TRANSPLANT

SEBASTİAN CAMMANN, KAİ TİMROTT, FLORİAN W R VONDRAN, HARALD SCHREM, FRANK LEHNER, JÜRGEN KLEMPNAUER, WOLFGANG KNİTSCH, MORİTZ KLEİNE

Experimental and Clinical Transplantation - 2018;16(5):631-634

General, Visceral, and Transplant Surgery, Hannover Medical School, Hannover, Germany

 

Objectives: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. Materials and Methods: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant. Results: When compared with tracheostomy performed > 3 days after transplant, early tracheostomy (≤ 3 days) had a higher likelihood of a brief duration of mechanical ventilation (62.5% vs 9.7%; P = .001). Accordingly, time spent in an intensive care unit was shorter with early tracheostomy. Conclusions: This study provides a retrospective analysis of a small study cohort; therefore, validation of our findings requires a prospective randomized multicenter study on early tracheostomy in respiratory high-risk liver transplant recipients.