Early Tracheostomy Reduces Time of Mechanical Ventilation in Respiratory High-Risk Patients After Liver Transplant.

Objectives: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. Materials and Methods: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant. Results: When compared with tracheostomy performed > 3 days after transplant, early tracheostomy (<= 3 days) had a higher likelihood of a brief duration of mechanical ventilation (62.5% vs 9.7%; P = .001). Accordingly, time spent in an intensive care unit was shorter with early tracheostomy. Conclusions: This study provides a retrospective analysis of a small study cohort; therefore, validation of our findings requires a prospective randomized multicenter study on early tracheostomy in respiratory high-risk liver transplant recipients.