title: Tracheostomy following lung transplantation predictors and outcomes.
abstract: The effect of tracheostomy on patients receiving lung transplantation is unknown. We reviewed our experience by performing a retrospective analysis on all lung transplant recipients at our institution. Patients were assigned to each study group based on whether or not they received a tracheostomy in the acute postoperative period. One hundred and fourteen lung transplants were performed, and 16 of those patients received a tracheostomy. In the tracheostomy group, more patients had undergone bilateral-lung transplantation (81% vs. 34%, p = 0.001), more required cardiopulmonary bypass (75% vs. 38%, p = 0.005), more acquired postoperative pneumonia (88% vs. 30%, p < 0.001), had greater reperfusion injury at 48 h (PaO2/FiO2 of 233 vs. 345, p = 0.047), had longer initial periods on the ventilator (21 +/- 7 vs. 2 +/- 0.5 days, p < 0.001), more required re-intubation (56% vs. 18%, p = 0.001), spent longer times in the intensive care unit (30 +/- 7 vs. 5.5 +/- 0.9 days, p < 0.001), and had longer lengths of stay (67 +/- 10 vs. 22 +/- 2 days, p < 0.001). Despite these differences between the two groups, a significant difference in survival at 180 days (75 vs. 81%) did not exist (p = 0.89). Although tracheostomy is more likely in sicker patients, it is not associated with poor long-term outcomes.
authors.affiliation: Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Siddharth A
authors.initials: SA
authors.lastname: Padia
authors.forename: Marvin C
authors.initials: MC
authors.lastname: Borja
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Orens
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Yang
authors.forename: Rajiv M
authors.initials: RM
authors.lastname: Jhaveri
authors.forename: John V
authors.initials: JV
authors.lastname: Conte
mesh_terms: D000328:Adult; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000401:mortality / Q000628:therapy; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013534:Survival; D014139:Tracheostomy / Q000706:statistics & numerical data*