title: Immediate extubation after pediatric liver transplantation: a single-center experience.
abstract: The care of pediatric liver transplant recipients has traditionally included postoperative mechanical ventilation. In 2005, we started extubating children undergoing liver transplantation in the operating room according to standard criteria for extubation used for general surgery cases. We reviewed our single-center experience to determine our rates of immediate extubation and practice since that time. The records of 84 children who underwent liver transplantation from 2005 to 2011 were retrospectively reviewed. The immediate extubation rate increased from 33% during 2005-2008 to 67% during 2009-2011. Immediate extubation did not result in an increased reintubation rate in comparison with delayed extubation in the intensive care unit (ICU). Patients undergoing immediate extubation had a trend toward a shorter mean ICU stay as well as a significantly decreased overall hospital length of stay. Our findings suggest that there is a learning curve for instituting immediate extubation in the operating room after liver transplantation and that the majority of pediatric liver recipients can safely undergo immediate extubation.
authors.affiliation: Departments of Surgery, Boston Children's Hospital, Boston, MA.
authors.forename: Nora M
authors.initials: NM
authors.lastname: Fullington
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Cauley
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Potanos
authors.forename: Laura
authors.initials: L
authors.lastname: O'Melia
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.forename: Heung
authors.initials: H
authors.lastname: Bae Kim
authors.forename: Christian
authors.initials: C
authors.lastname: Seefelder
authors.forename: Khashayar
authors.initials: K
authors.lastname: Vakili
mesh_terms: D000367:Age Factors; D060666:Airway Extubation / Q000009:adverse effects; D001900:Boston; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D059032:Learning Curve; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications / Q000628:therapy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome