title: Predicting the Necessity for Extracorporeal Circulation During Lung Transplantation: A Feasibility Study.
abstract: OBJECTIVE
  The factors leading to the implementation of unplanned extracorporeal circulation during lung transplantation are poorly defined. Consequently, the authors aimed to identify patients at risk for unplanned extracorporeal circulation during lung transplantation.
  
  
  METHODS
  Retrospective data analysis.
  
  
  METHODS
  Single-center university hospital.
  
  
  METHODS
  A development data set of 170 consecutive patients and an independent validation cohort of 52 patients undergoing lung transplantation.
  
  
  METHODS
  The authors investigated a cohort of 170 consecutive patients undergoing single or sequential bilateral lung transplantation without a priori indication for extracorporeal circulation and evaluated the predictive capability of distinct preoperative and intraoperative variables by using automated model building techniques at three clinically relevant time points (preoperatively, after endotracheal intubation, and after establishing single-lung ventilation).
  
  
  RESULTS
  Preoperative mean pulmonary arterial pressure was the strongest predictor for unplanned extracorporeal circulation. A logistic regression model based on preoperative mean pulmonary arterial pressure and lung allocation score achieved an area under the receiver operating characteristic curve of 0.85. Consequently, the authors developed a novel 3-point scoring system based on preoperative mean pulmonary arterial pressure and lung allocation score, which identified patients at risk for unplanned extracorporeal circulation and validated this score in an independent cohort of 52 patients undergoing lung transplantation.
  
  
  CONCLUSIONS
  The authors showed that patients at risk for unplanned extracorporeal circulation during lung transplantation could be identified by their novel 3-point score.
authors.affiliation: Department of Anesthesiology, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Ludwig Christian
authors.initials: LC
authors.lastname: Hinske
authors.affiliation: Department of Anesthesiology, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Dominik Johannes
authors.initials: DJ
authors.lastname: Hoechter
authors.affiliation: Department of Anesthesiology, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Schröeer
authors.affiliation: Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Kneidinger
authors.affiliation: Department of Cardiac Surgery, University Hospital Ludwig-Maximillians-University Munich, Munich, Germany.
authors.forename: René
authors.initials: R
authors.lastname: Schramm
authors.affiliation: Division of Thoracic Surgery, University Hospital Ludwig-Maximillians-University Munich, Munich, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Preissler
authors.affiliation: Department of Anesthesiology, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Tomasi
authors.affiliation: Transplantation Center Munich, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Alma
authors.initials: A
authors.lastname: Sisic
authors.affiliation: Department of Anesthesiology, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Frey
authors.affiliation: Department of Anesthesiology, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Vera
authors.initials: V
authors.lastname: von Dossow
authors.affiliation: Department of Anesthesiology, Comprehensive Pneumology Center (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany. Electronic address: patrick.scheiermann@med.uni-muenchen.de.
authors.forename: Patrick
authors.initials: P
authors.lastname: Scheiermann
mesh_terms: D015331:Cohort Studies; D005112:Extracorporeal Circulation / Q000706:statistics & numerical data* / Q000639:trends*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D016040:Lung Transplantation / Q000639:trends*; D008297:Male; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D011897:Random Allocation; D012189:Retrospective Studies
keywords: automated model building techniques; extracorporeal circulation; lung transplantation; mathematical modeling; prediction model