title: Postoperative complications in the intensive care unit following lung transplantation in adults: results in University Hospital Reina Sofia.
abstract: The postoperative period following lung transplantation remains critical because of several complications. Infection, primary graft failure, acute rejection, and surgical complications are risk factors for mortality and morbidity. The recognition and early treatment of these complications is important to optimize outcomes. This article provides an overview of postoperative complications observed in our center during the last year. We were particularly interested in the influence of variables, such as inotrope usage and Acute Physiology and Chronic Health Evaluation (APACHE II) score, a well-known, and validated mortality prediction model for general intensive care unit (ICU) patients only infrequently reported in the transplantation literature. High APACHE II scores were significantly associated with prolonged mechanical ventilation (P = 0.041) and a tracheostomy requirement (P = .035). The factors significantly associated with an early postoperative death were older donor age (P = .005), prolonged donor ICU period (P = .004), need for cardiopulmonary bypass (CB; P = .005), and high inotrope requirements in the ICU (P = .034). CB data were biased because we selected the worst case patients. Donor age and high inotrope requirements in the ICU have been reported previously to be prognostic factors for poor graft function. We believe that control of these variables may improve outcomes.
authors.affiliation: Thoracic Surgery and Lung Transplantation Unit, University Hospital Reina Sofía, Córdoba, Spain. eli_piano@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Arango Tomás
authors.forename: M I
authors.initials: MI
authors.lastname: Quero Ríos
authors.forename: J C
authors.initials: JC
authors.lastname: Robles Arista
authors.forename: F J
authors.initials: FJ
authors.lastname: Algar Algar
authors.forename: J I
authors.initials: JI
authors.lastname: Wolf
authors.forename: A
authors.initials: A
authors.lastname: Alvarez Kindelan
authors.forename: F
authors.initials: F
authors.lastname: Cerezo Madueño
authors.forename: C
authors.initials: C
authors.lastname: Baamonde Laborda
authors.forename: R
authors.initials: R
authors.lastname: Guerrero Pabon
authors.forename: A
authors.initials: A
authors.lastname: Salvatierra Velazquez
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D002316:Cardiotonic Agents / Q000627:therapeutic use; D046148:Donor Selection; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012121:Respiration, Artificial; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors; D014139:Tracheostomy; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents