Ventilatory support and hospital stay after liver transplant in cirrhotic patients with hepatopulmonary syndrome

ABSTRACT Objective To compare mechanical ventilation time, need for non-invasive ventilation, length of intensive care unit stay, and hospital stay after liver transplant in cirrhotic patients with and with no diagnosis of hepatopulmonary syndrome. Methods This was a prospective cohort study with a convenience sample of 178 patients (92 with hepatopulmonary syndrome) who were diagnosed as alcoholic or hepatitis C virus cirrhosis. The statistical analysis included Kolmogorov-Smirnov test and Students t test. Data were analyzed using SPSS version 16.0, and p values <0.05 were considered significant. Results Out of 178 patients, 90 underwent transplant (48 with no hepatopulmonary syndrome). The Group diagnosed with Hepatopulmonary Syndrome had longer mechanical ventilation time (19.5±4.3 hours versus 12.5±3.3 hours; p=0.02), an increased need for non-invasive ventilation (12 versus 2; p=0.01), longer intensive care unit stay (6.7±2.1 days versus 4.6±1.5 days; p=0.02) and longer hospital stay (24.1±4.3 days versus 20.2±3.9 days; p=0.01). Conclusion Cirrhotic patients Group diagnosed with Hepatopulmonary Syndrome had higher mechanical ventilation time, more need of non-invasive ventilation, as well as longer intensive care unit and hospital stay.

【摘要】目的 对比合并与未合并肝肺综合征（hepatopulmonary syndrome）的肝硬化患者在肝移植术后的机械通气时长、无创通气需求、重症监护病房停留时长及住院时长。方法 本研究为前瞻性队列研究，采用便利抽样法纳入178例患者（其中92例合并肝肺综合征），均确诊为酒精性或丙型肝炎病毒相关性肝硬化。统计学分析采用Kolmogorov-Smirnov检验及Student t检验，使用SPSS 16.0软件进行数据分析，以P<0.05为差异具有统计学意义。结果 178例患者中共计90例接受肝移植（其中48例未合并肝肺综合征）。合并肝肺综合征组的机械通气时长更长（19.5±4.3小时 vs 12.5±3.3小时；P=0.02），无创通气需求更高（12例 vs 2例；P=0.01），重症监护病房停留时长更长（6.7±2.1天 vs 4.6±1.5天；P=0.02），住院时长更长（24.1±4.3天 vs 20.2±3.9天；P=0.01）。结论 合并肝肺综合征的肝硬化患者术后机械通气时长更长、无创通气需求更高，重症监护病房及住院停留时长也更久。