Early Critical Care Course in Children after Liver Transplant
Objective. To review the critical care course of children receiving orthotopic liver transplantation (OLT). Methods. A retrospective chart review of patients admitted to the pediatric critical care following OLT performed in our center between 1988 and 2011. Results. A total of 149 transplants in 14...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2014/725748 |
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| author | Vinay Kukreti Hani Daoud Sundeep S. Bola Ram N. Singh Paul Atkison Alik Kornecki |
| author_facet | Vinay Kukreti Hani Daoud Sundeep S. Bola Ram N. Singh Paul Atkison Alik Kornecki |
| author_sort | Vinay Kukreti |
| collection | DOAJ |
| description | Objective. To review the critical care course of children receiving orthotopic liver transplantation (OLT). Methods. A retrospective chart review of patients admitted to the pediatric critical care following OLT performed in our center between 1988 and 2011. Results. A total of 149 transplants in 145 patients with a median age of 2.7 (IQR 0.9–7) years were analyzed. Mortality in the first 28 days was 8%. The median length of stay (LOS) was 7 (4.0–12.0) days. The median length of mechanical ventilation (MV) was 3 (1.0–6.2) days. Open abdomen, age, and oxygenation index on the 2nd day predicted LOS. Open abdomen, age, amount of blood transfused during surgery, and PRISM III predicted length of MV. 28% of patients had infection and 24% developed acute rejection. In recent group (2000–2011) OLT was performed in younger patients; the risk of infection and acute rejection was reduced and patients required longer LOS and MV compared with old group (1988–1999). Conclusion. The postoperative course of children after OLT is associated with multiple complications. In recent years OLT was performed in younger children; living donors were more common; the rate of postoperative infection and suspected rejection was reduced significantly; however patients required longer MV and LOS in the PCCU. |
| format | Article |
| id | doaj-art-d8ff6b0be7b2484c9943a26df5c7e956 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-d8ff6b0be7b2484c9943a26df5c7e9562025-08-20T03:24:22ZengWileyCritical Care Research and Practice2090-13052090-13132014-01-01201410.1155/2014/725748725748Early Critical Care Course in Children after Liver TransplantVinay Kukreti0Hani Daoud1Sundeep S. Bola2Ram N. Singh3Paul Atkison4Alik Kornecki5Department of Pediatric Critical Care Medicine, Children’s Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, P.O. Box 5010, London, ON, N6A 5W9, CanadaDepartment of Pediatric Critical Care Medicine, Children’s Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, P.O. Box 5010, London, ON, N6A 5W9, CanadaDivision of Respiratory Medicine, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, CanadaDepartment of Pediatric Critical Care Medicine, Children’s Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, P.O. Box 5010, London, ON, N6A 5W9, CanadaDepartment of Pediatrics, Children’s Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, P.O. Box 5010, London, ON, N6A 5W9, CanadaDepartment of Pediatric Critical Care Medicine, Children’s Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, P.O. Box 5010, London, ON, N6A 5W9, CanadaObjective. To review the critical care course of children receiving orthotopic liver transplantation (OLT). Methods. A retrospective chart review of patients admitted to the pediatric critical care following OLT performed in our center between 1988 and 2011. Results. A total of 149 transplants in 145 patients with a median age of 2.7 (IQR 0.9–7) years were analyzed. Mortality in the first 28 days was 8%. The median length of stay (LOS) was 7 (4.0–12.0) days. The median length of mechanical ventilation (MV) was 3 (1.0–6.2) days. Open abdomen, age, and oxygenation index on the 2nd day predicted LOS. Open abdomen, age, amount of blood transfused during surgery, and PRISM III predicted length of MV. 28% of patients had infection and 24% developed acute rejection. In recent group (2000–2011) OLT was performed in younger patients; the risk of infection and acute rejection was reduced and patients required longer LOS and MV compared with old group (1988–1999). Conclusion. The postoperative course of children after OLT is associated with multiple complications. In recent years OLT was performed in younger children; living donors were more common; the rate of postoperative infection and suspected rejection was reduced significantly; however patients required longer MV and LOS in the PCCU.http://dx.doi.org/10.1155/2014/725748 |
| spellingShingle | Vinay Kukreti Hani Daoud Sundeep S. Bola Ram N. Singh Paul Atkison Alik Kornecki Early Critical Care Course in Children after Liver Transplant Critical Care Research and Practice |
| title | Early Critical Care Course in Children after Liver Transplant |
| title_full | Early Critical Care Course in Children after Liver Transplant |
| title_fullStr | Early Critical Care Course in Children after Liver Transplant |
| title_full_unstemmed | Early Critical Care Course in Children after Liver Transplant |
| title_short | Early Critical Care Course in Children after Liver Transplant |
| title_sort | early critical care course in children after liver transplant |
| url | http://dx.doi.org/10.1155/2014/725748 |
| work_keys_str_mv | AT vinaykukreti earlycriticalcarecourseinchildrenafterlivertransplant AT hanidaoud earlycriticalcarecourseinchildrenafterlivertransplant AT sundeepsbola earlycriticalcarecourseinchildrenafterlivertransplant AT ramnsingh earlycriticalcarecourseinchildrenafterlivertransplant AT paulatkison earlycriticalcarecourseinchildrenafterlivertransplant AT alikkornecki earlycriticalcarecourseinchildrenafterlivertransplant |