PDF(Pubmed)
Abstract：
BACKGROUND: Pediatric patients undergoing liver transplantation are particularly susceptible to complications arising from intraoperative fluid management strategies. Conventional liberal fluid administration has been challenged due to its association with increased perioperative morbidity. This study aimed to assess the impact of intraoperative high-volume fluid therapy on pediatric patients who are undergoing living donor liver transplantation (LDLT).
METHODS: Conducted at the Children\'s Hospital of Chongqing Medical University from March 2018 to April 2021, this retrospective study involved 90 pediatric patients divided into high-volume and non-high-volume fluid administration groups based on the 80th percentile of fluid administered. We collected the perioperative parameters and postoperative information of two groups. Multivariable logistic regression was utilized to assess the association between estimated blood loss (EBL) and high-volume FA. Kaplan-Meier survival analysis was used to compare patient survival after pediatric LDLT.
RESULTS: Patients in the high-volume FA group received a higher EBL and longer length of stay than that in the non-high-volume FA group. Multivariate logistic regression analysis indicated that hours of maintenance fluids and fresh frozen plasma were significantly associated risk factors for the occurrence of EBL during pediatric LDLT. In addition, survival analysis showed no significant differences in one-year mortality between the groups.
CONCLUSIONS: High-volume fluid administration during LDLT is linked with poorer intraoperative and postoperative outcomes among pediatric patients. These findings underscore the need for more conservative fluid management strategies in pediatric liver transplantations to enhance recovery and reduce complications.
METHODS: Conducted at the Children\'s Hospital of Chongqing Medical University from March 2018 to April 2021, this retrospective study involved 90 pediatric patients divided into high-volume and non-high-volume fluid administration groups based on the 80th percentile of fluid administered. We collected the perioperative parameters and postoperative information of two groups. Multivariable logistic regression was utilized to assess the association between estimated blood loss (EBL) and high-volume FA. Kaplan-Meier survival analysis was used to compare patient survival after pediatric LDLT.
RESULTS: Patients in the high-volume FA group received a higher EBL and longer length of stay than that in the non-high-volume FA group. Multivariate logistic regression analysis indicated that hours of maintenance fluids and fresh frozen plasma were significantly associated risk factors for the occurrence of EBL during pediatric LDLT. In addition, survival analysis showed no significant differences in one-year mortality between the groups.
CONCLUSIONS: High-volume fluid administration during LDLT is linked with poorer intraoperative and postoperative outcomes among pediatric patients. These findings underscore the need for more conservative fluid management strategies in pediatric liver transplantations to enhance recovery and reduce complications.
摘要：
背景：接受肝移植的儿科患者特别容易发生术中液体管理策略引起的并发症。传统的自由液体给药由于其与围手术期发病率增加有关而受到挑战。本研究旨在评估术中高容量液体治疗对接受活体肝移植（LDLT）的儿科患者的影响。
方法：这项回顾性研究于2018年3月至2021年4月在重庆医科大学附属儿童医院进行，纳入90例儿科患者，根据液体给药的第80百分位数分为高容量和非高容量给药组。收集两组患者围手术期参数及术后资料。多变量逻辑回归用于评估估计失血量（EBL）与高容量FA之间的关联。使用Kaplan-Meier生存分析来比较小儿LDLT后患者的生存。
结果：与非高容量FA组相比，高容量FA组患者接受了更高的EBL和更长的住院时间。多因素logistic回归分析显示，小时数的维持液和新鲜冰冻血浆是小儿LDLT发生EBL的危险因素。此外,生存分析显示两组间1年死亡率无显著差异.
结论：LDLT期间的高容量液体给药与儿科患者的术中和术后预后较差有关。这些发现强调了在小儿肝移植中需要更保守的液体管理策略，以促进恢复并减少并发症。
方法：这项回顾性研究于2018年3月至2021年4月在重庆医科大学附属儿童医院进行，纳入90例儿科患者，根据液体给药的第80百分位数分为高容量和非高容量给药组。收集两组患者围手术期参数及术后资料。多变量逻辑回归用于评估估计失血量（EBL）与高容量FA之间的关联。使用Kaplan-Meier生存分析来比较小儿LDLT后患者的生存。
结果：与非高容量FA组相比，高容量FA组患者接受了更高的EBL和更长的住院时间。多因素logistic回归分析显示，小时数的维持液和新鲜冰冻血浆是小儿LDLT发生EBL的危险因素。此外,生存分析显示两组间1年死亡率无显著差异.
结论：LDLT期间的高容量液体给药与儿科患者的术中和术后预后较差有关。这些发现强调了在小儿肝移植中需要更保守的液体管理策略，以促进恢复并减少并发症。
