Analysis of risk factors of prolonged mechanical ventilation after lung transplantation
10.3969/j.issn.1674-7445.2022.06.016
- VernacularTitle:肺移植术后机械通气延长的危险因素分析
- Author:
Dapeng WANG
1
;
Xiaoshan LI
;
Chenhao XUAN
;
Chunxiao HU
;
Feng ZHANG
;
Yifeng WANG
;
Hongyang XU
Author Information
1. Department of Intensive Care Unit, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
- Publication Type:Research Article
- Keywords:
Lung transplantation;
Prolonged mechanical ventilation;
Mechanical ventilation time;
Liver function;
Renal function;
Risk factor;
Extracorporeal membrane oxygenation
- From:
Organ Transplantation
2022;13(6):797-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify the risk factors of prolonged mechanical ventilation (PMV) after lung transplantation. Methods Clinical data of 90 recipients undergoing lung transplantation were retrospectively analyzed. According to the duration of invasive mechanical ventilation after operation, all recipients were divided into the PMV group (ventilation duration > 48 h, n=30) and control group (ventilation duration≤48 h, n=60). Perioperative parameters were compared between two groups, including preoperative parameters [serum creatinine, estimated glomerular filtration rate (eGFR)], intraoperative parameters (cold ischemia time of donor lung, blood loss), and postoperative parameters [the first red blood cell, white blood cell, platelet count, hemoglobin, C-reactive protein, serum creatinine, total bilirubin, alanine aminotransferase (ALT), oxygenation index, eGFR and the mean arterial pressure in intensive care unit (ICU)]. The risk factors of PMV after lung transplantation were assessed by multivariate logistic regression analysis. Results Preoperative serum creatinine level in the PMV group was 62 (53, 67) μmol/L, significantly higher than 57 (47, 62) μmol/L in the control group. Preoperative eGFR in the PMV group was 97 (93, 107) mL/min, significantly lower than 106 (102, 116) mL/min in the control group. The first postoperative oxygenation index in the PMV group was 196 (157, 286) mmHg, significantly lower than 250 (199, 354) mmHg in the control group (all P < 0.05). Multivariate analysis showed that the first increase of postoperative total bilirubin, the first decrease of postoperative oxygenation index and preoperative eGFR decrease were the independent risk factors for PMV following lung transplantation. Conclusions The first increase of postoperative total bilirubin, the first decrease of postoperative oxygenation index and preoperative eGFR decrease are the independent risk factors for PMV after lung transplantation.
