Korean J Crit Care Med.  2009 Aug;24(2):69-74. 10.4266/kjccm.2009.24.2.69.

Evaluating the Relationship between the Scoring Systems of Intensive Care Units (ICUs) and the Duration of Mechanical Ventilation after Liver Transplantation

• Kim JE
• Lee SH
• Choi JH

• KMID: 2228349
• DOI: http://doi.org/10.4266/kjccm.2009.24.2.69

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.

Keyword

APACHE II score; liver transplantation; mechanical ventilation; MELD score; SOFA score

MeSH Terms

APACHE
Humans
Critical Care
Intensive Care Units
Liver
Liver Diseases
Liver Transplantation
Living Donors
Respiration, Artificial
Retrospective Studies
Transplants