간이식 환자에서 술 후 기계환기 기간과 중환자 지표들의 연관성에 대한 연구
Evaluating the Relationship between the Scoring Systems of Intensive Care Units (ICUs) and the Duration of Mechanical Ventilation after Liver Transplantation
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Postoperative mechanical ventilation in liver transplant patient has an important role for reducing respiratory complications and multi-organ failure in intensive care unit (ICU). Yet there are no specific indications for predicting the duration of postoperative mechanical ventilation. Thus, we evaluated the correlation between the duration of mechanical ventilation and scoring systems such as the Acute Physiology and Chronic health Evaluation (APACHE) II score, the Sequential Organ Failure Assessment (SOFA) score, the Model for End-stage Liver Disease (MELD) score and the risk index. Methods: We retrospectively studied 183 patients who underwent living donor liver transplantation and we divided them into three groups based on the duration of mechanical ventilation: Group 1: ＜8 hr, Group 2: 8-12 hr and Group 3: ＞12 hr. We analyzed the correlation coefficients among the duration of mechanical ventilation, the risk index, and the SOFA, APACHE II and MELD scores. Results: The MELD and preoperative SOFA scores were significantly higher in group 3 (p=0.003, p=0.027). The MELD and SOFA scores were correlated with the duration of mechanical ventilation for all the patients (correlation coefficient=0.22, 0.20, p=0.003, 0.007, respectively). Yet the APACHE II score shows no correlation. Conclusions: We found that the MELD and SOFA scores were correlated with the duration of mechanical ventilation in liver transplant patients. Thus, these scoring systems may be useful to determine the duration of mechanical ventilation.
Abstract
Background: Postoperative mechanical ventilation in liver transplant patient has an important role for reducing respiratory complications and multi-organ failure in intensive care unit (ICU). Yet there are no specific indications for predicting the duration of postoperative mechanical ventilation. Thus, we evaluated the correlation between the duration of mechanical ventilation and scoring systems such as the Acute Physiology and Chronic health Evaluation (APACHE) II score, the Sequential Organ Failure Assessment (SOFA) score, the Model for End-stage Liver Disease (MELD) score and the risk index. Methods: We retrospectively studied 183 patients who underwent living donor liver transplantation and we divided them into three groups based on the duration of mechanical ventilation: Group 1: ＜8 hr, Group 2: 8-12 hr and Group 3: ＞12 hr. We analyzed the correlation coefficients among the duration of mechanical ventilation, the risk index, and the SOFA, APACHE II and MELD scores. Results: The MELD and preoperative SOFA scores were significantly higher in group 3 (p=0.003, p=0.027). The MELD and SOFA scores were correlated with the duration of mechanical ventilation for all the patients (correlation coefficient=0.22, 0.20, p=0.003, 0.007, respectively). Yet the APACHE II score shows no correlation. Conclusions: We found that the MELD and SOFA scores were correlated with the duration of mechanical ventilation in liver transplant patients. Thus, these scoring systems may be useful to determine the duration of mechanical ventilation.
참고문헌 (21)
- Hwang S, "Perioperative intensive care for liver transplantation", Korean J Crit Care Med, 16, pp.5~10 (2001)
- Carton EG, "Perioperative care of the liver transplant patient: part 2", Anesth Analg, 78, pp.382~399 (1994)
- Plevak DJ, "Intensive care unit experience in the Mayo liver transplant program: the first 100 cases", Mayo Clin Proc, 통권 : 64, pp.433~445 (1989)
- Stock PG, "Liver transplantation", Crit Care Clin, 6, pp.911~926 (1990)
- Plevak DJ, "Fast tracking in liver transplantation", Liver Transpl Surg, 3, pp.447~448 (1997)
- Higgins JL, "Pro: early endotracheal extubaion is preferable to late extubation in patients following coronary artery surgery", J Cardiothorac Vasc Anesth, 6, pp.488~493 (1992)
- Kaisers U, "Hepatic venous catheterization in patients undergoing positive end-expiratory pressure ventilation after OLT: technique and clinical impact", Clin Transplant, 9, pp.301~306 (1995)
- Glanemann M, "Incidence and risk factors of prolonged mechanical ventilation and causes of reintubation after liver transplantation", Transplant Proc, 통권 : 30, pp.1874~1875 (1998)
- Knaus WA, "APACHE II: a severity of disease classification system", Crit Care Med, 13, pp.818~829 (1985)
- Oh TE, "Verification of the Acute Physiology and Chronic Health Evaluation scoring system in a Hong Kong intensive care unit", Crit Care Med, 21, pp.698~705 (1993)
- Rowan KM, "Intensive Care Society’s Acute Physiology and Chronic Health Evaluation (APACHE II) study in Britain and Ireland: a prospective, multicenter, cohort study comparing two methods for predicting outcome for adult intensive care patients", Crit Care Med, 22, pp.1392~1401 (1994)
- Livingston BM, "Assessment of the performance of five intensive care scoring models within a large Scottish database", Crit Care Med, 28, pp.1820~1827 (2000)
- Ho KM, "Combining sequential organ failure assessment (SOFA) score with acute physiology and chronic health evaluation (APACHE) II score to predict mortality of critically ill patients", Anaesth Intensive Care, 35, pp.515~521 (2007)
- Vincent JL, "The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction", failure. On behalf of the working group on sepsis-related problems of the European society of intensive care medicine, 1996, pp.22, 707~710
- Wiesner R, "Model for end-stage liver disease (MELD) and allocation of donor livers", Gastroenterology, 124, pp.91~96 (2003)
- Choi JH, "Evaluation of usefulness of perioperative risk factors which affect early or delayed extubation after liver transplantation", Korean J Anesthesiology, 44, pp.847~852 (2003)
- Cholongitas E, "Risk factors, sequential organ failure assessment and model for end-stage liver disease scores for predicting short term mortality in cirrhotic patients admitted to intensive care unit", Aliment Pharmacol Ther, 23, pp.883~893 (2006)
- Cholingitas E, "Review article: scoring systems for assessing prognosis in critically ill adult cirrhotics", Aliment Pharmacol Ther, 24, pp.453~464 (2006)
- Wehler M, "Short-term prognosis in critically ill patients with cirrhosis assessed by prognostic scoring systems", Hepatology, 34, pp.255~261 (2001)
- Gardía S, "Infection and associated risk factors in the immediate postoperative period of pediatric liver transplantation: a study of 176 transplants", Clin Transplant, 12, pp.190~197 (1998)
- Spanier TB, "Multiple organ failure after liver transplantation", Crit Care Med, 23, pp.466~473 (1995)