[Invasive mechanical ventilation in cystic fibrosis: Influence in lung transplant].
BACKGROUND
Invasive mechanical ventilation (IMV) in patients with advanced cystic fibrosis (CF) is a relative contraindication for lung transplant (LT) in adults, although there is currently no data on children.


METHODS
An 8-year retrospective study on 21 children with CF who underwent LT was performed, analysing their results as they were receiving (n = 8) or not (n = 13) IMV pretransplant. Demographic and surgical data, postoperative course, lung function and survival (immediate and 1-year) were compared between both groups. The role of the IMV pretransplant as a postoperative risk factor was estimated (odds ratio) and Kaplan Meier survival study was performed in both groups.


RESULTS
No differences in patient age, sex and nutritional parameters were observed between both groups. Those on IMV who received LT required more frequent and longer bypass, more need for tracheotomy, a higher number of rejection episodes per patient and multiorgan failure, longer PICU stay and longer time on IMV than those who were not on IMV when LT was received. Nevertheless, no differences could be found regarding graft function and immediate and 1-year survivals (62.5% vs. 92.3% with and without IMV respectively). On the other hand, long-term survival was significantly lower than in patients on IMV.


CONCLUSIONS
In our experience, children with CF on IMV who receive LT have more complicated surgery and immediate postoperative course. Though immediate and 1-year results and survivals may be encouraging, medium and long-term ones are significantly lower.
Frías Pérez
M A
MA
Unidad de Cuidados Intensivos Pediátricos, Servicio de Pediatría, Hospital Universitario Reina Sofía, Córdoba, España.
Ibarra de la Rosa
I
I
García Menor
E
E
Santos Luna
F
F
Ulloa Santamaría
E
E
Velasco Jabalquinto
M J
MJ
Jaraba Caballero
S
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D003550:Cystic Fibrosis / Q000628:therapy*; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies