Acute respiratory distress syndrome after orthotopic liver transplantation

Wei Zhao, Xupeng Ge, Kai Sun, Vatche G. Agopian, Yuelan Wang, Min Yan, Ronald W. Busuttil, Randolph H. Steadman, Victor W. Xia

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Purpose Acute respiratory distress syndrome (ARDS) is a devastating complication with substantial mortality. The aims of this study were to identify the incidence, preoperative and intraoperative risk factors, and impact of ARDS on outcomes in patients after orthotopic liver transplantation (OLT). Materials and methods Adult OLT patients between January 2004 and October 2013 at our center were included. Postoperative ARDS was determined using the criteria proposed by the Berlin Definition. Multivariate logistic models were used to identify preoperative and intraoperative risk factors for ARDS. Results Of 1726 patients during the study period, 71 (4.1%) developed ARDS. In the preoperative model, encephalopathy (odds ratio [OR], 2.22; P =.022), preoperative requirement of intubation (OR, 2.06; P =.020), and total bilirubin (OR, 1.02; P =.003) were independent risk factors. In the intraoperative model, large pressor bolus was the sole risk factor for ARDS (OR, 2.69; P =.001). Postoperatively, patients with ARDS had a 2-fold increase in 1-year mortality, mechanical ventilation time, and length of hospital stay. Conclusions Acute respiratory distress syndrome occurred at a rate of 4.1% following OLT in adult patients and was associated with preoperative encephalopathy, requirement of intubation, and total bilirubin and intraoperative large boluses of pressors. Acute respiratory distress syndrome was associated with increased mortality, longer ventilation time, and hospital stay.

Original languageEnglish (US)
Pages (from-to)163-167
Number of pages5
JournalJournal of Critical Care
Volume31
Issue number1
DOIs
StatePublished - Feb 1 2016

Keywords

  • Acute respiratory distress syndrome
  • Liver transplantation
  • Perioperative management
  • Postoperative complication
  • Retrospective study
  • Risk factors

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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