Application value of perioperative intensive airway management in prevention of lung infection after liver transplantation

Abstract

Objective To investigate the application value of perioperative intensive airway management in prevention of lung infection after liver transplantation (LT). Methods Clinical data of 914 patients undergoing LT in the Third Affiliated Hospital of Sun Yat-sen University between January 2004 and September 2014 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. All patients were transferred into ICU after LT. According to whether the intensive airway management was performed during the perioperative period, the patients were divided into the group with airway management (the study group) and the group without airway management (the control group). Among the 170 patients of study group, 152 were males and 18 were females with the average age of (48±11) years old. Among the 744 patients of control group, 655 were males and 89 were females with the average age of (49±12) years old. The measures of intensive airway management included the basic nursing of strengthening back-slapping for excreting phlegm and respiratory function exercise, maintaining gastrointestinal decompression and clear drainage, preventing aspiration, moistening airway, aseptic suction, also included reducing the use of ventilator, giving aerosol inhalation of budesonide and ambroxol within 12-24 h after anesthetic awareness, performing sputum suction by fiberoptic bronchoscopy when necessary to ensure sputum excretion from airway. The incidence of lung infection and mortality within 1 month after LT of the two groups were compared. The infection incidence and mortality between two groups were compared using Chi-square test. Results The incidence of lung infection of study group was 17.1% (29/170), which was significantly lower than 28.9% (215/744) of control group (χ2=9.91, P<0.05). The mortality 1 month after LT of study group was 4.1% (7/170), which was significantly lower than 10.1% (75/744) of control group (χ2=6.03, P<0.05). Conclusion Perioperative intensive airway management can significantly reduces the incidence of perioperative lung infection and mortality after LT. Key words: Liver transplantation; Respiratory tract infections; Perioperative care