title: Acute Respiratory Failure in Cardiac Transplant Recipients.
abstract: OBJECTIVE
  This study sought to evaluate the incidence, risk factors, and outcomes of acute respiratory failure in cardiac transplant recipients.
  
  
  METHODS
  Cardiac transplant recipients >15 years of age and readmitted to the intensive care unit after cardiac transplant between 2005 and 2015 were included.
  
  
  RESULTS
  Thirty-nine patients were included in the final analyses. Patients with acute respiratory failure and without acute respiratory failure were compared. The most frequent causes of readmission were routine intensive care unit follow-up after endomyocardial biopsy, heart failure, sepsis, and pneumonia. Patients who were readmitted to the intensive care unit were further divided into 2 groups based on presence of acute respiratory failure. Patients' ages and body weights did not differ between groups. The groups were not different in terms of comorbidities. The admission sequential organ failure assessment scores were higher in patients with acute respiratory failure. Patients with acute respiratory failure were more likely to use bronchodilators and n-acetylcysteine before readmission. Mean peak inspiratory pressures were higher in patients in acute respiratory failure. Patients with acute respiratory failure developed sepsis more frequently and they were more likely to have hypotension. Patients with acute respiratory failure had higher values of serum creatinine before admission to intensive care unit and in the first day of intensive care unit. Patients with acute respiratory failure had more frequent bilateral opacities on chest radiographs and positive blood and urine cultures. Duration of intensive care unit and hospital stays were not statistically different between groups. Mortality in patients with acute respiratory failure was 76.5% compared with 0% in patients without acute respiratory failure.
  
  
  CONCLUSIONS
  A significant number of cardiac transplant recipients were readmitted to the intensive care unit. Patients presenting with acute respiratory failure on readmission more frequently developed sepsis and hypotension, suggesting a poorer prognosis.
authors.affiliation: From Baskent University, School of Medicine, Department of Anesthesiology and Critical Care Medicine, Ankara, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Komurcu
authors.forename: Aycan
authors.initials: A
authors.lastname: Ozdemirkan
authors.forename: Aynur
authors.initials: A
authors.lastname: Camkiran Firat
authors.forename: Pinar
authors.initials: P
authors.lastname: Zeyneloglu
authors.forename: Atilla
authors.initials: A
authors.lastname: Sezgin
authors.forename: Arash
authors.initials: A
authors.lastname: Pirat
mesh_terms: D000208:Acute Disease; D000328:Adult; D015897:Comorbidity; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007022:Hypotension / Q000209:etiology; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010359:Patient Readmission; D012042:Registries; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome