Cargando…

Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome

BACKGROUND: Risk factors and the incidence of prolonged mechanical ventilation (PMV) after lung transplantation (LT) have been poorly described. The study assessed predictive factors of PMV after LT. METHODS: This observational, retrospective, monocentric study included all patients who received LT...

Descripción completa

Detalles Bibliográficos
Autores principales: Atchade, Enora, Boughaba, Aimane, Dinh, Alexy Tran, Jean-Baptiste, Sylvain, Tanaka, Sébastien, Copelovici, Léa, Lortat-Jacob, Brice, Roussel, Arnaud, Castier, Yves, Messika, Jonathan, Mal, Hervé, de Tymowski, Christian, Montravers, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10203407/
https://www.ncbi.nlm.nih.gov/pubmed/37228395
http://dx.doi.org/10.3389/fmed.2023.1160621
_version_ 1785045624063787008
author Atchade, Enora
Boughaba, Aimane
Dinh, Alexy Tran
Jean-Baptiste, Sylvain
Tanaka, Sébastien
Copelovici, Léa
Lortat-Jacob, Brice
Roussel, Arnaud
Castier, Yves
Messika, Jonathan
Mal, Hervé
de Tymowski, Christian
Montravers, Philippe
author_facet Atchade, Enora
Boughaba, Aimane
Dinh, Alexy Tran
Jean-Baptiste, Sylvain
Tanaka, Sébastien
Copelovici, Léa
Lortat-Jacob, Brice
Roussel, Arnaud
Castier, Yves
Messika, Jonathan
Mal, Hervé
de Tymowski, Christian
Montravers, Philippe
author_sort Atchade, Enora
collection PubMed
description BACKGROUND: Risk factors and the incidence of prolonged mechanical ventilation (PMV) after lung transplantation (LT) have been poorly described. The study assessed predictive factors of PMV after LT. METHODS: This observational, retrospective, monocentric study included all patients who received LT in Bichat Claude Bernard Hospital between January 2016 and December 2020. PMV was defined as a duration of MV > 14 days. Independent risk factors for PMV were studied using multivariate analysis. One-year survival depending on PMV was studied using Kaplan Meier and log-rank tests. A p value <0.05 was defined as significant. RESULTS: 224 LT recipients were analysed. 64 (28%) of them received PMV for a median duration of 34 [26–52] days versus 2 [1–3] days without PMV. Independent risk factors for PMV were higher body mass index (BMI) (p = 0.031), diabetes mellitus of the recipient (p = 0.039), ECMO support during surgery (p = 0.029) and intraoperative transfusion >5 red blood cell units (p < 0.001). Increased mortality rates were observed at one-year in recipients who received PMV (44% versus 15%, p < 0.001). CONCLUSION: PMV was associated with increased morbidity and mortality one-year after LT. Preoperative risk factors (BMI and diabetes mellitus) must be considered when selecting and conditioning the recipients.
format Online
Article
Text
id pubmed-10203407
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-102034072023-05-24 Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome Atchade, Enora Boughaba, Aimane Dinh, Alexy Tran Jean-Baptiste, Sylvain Tanaka, Sébastien Copelovici, Léa Lortat-Jacob, Brice Roussel, Arnaud Castier, Yves Messika, Jonathan Mal, Hervé de Tymowski, Christian Montravers, Philippe Front Med (Lausanne) Medicine BACKGROUND: Risk factors and the incidence of prolonged mechanical ventilation (PMV) after lung transplantation (LT) have been poorly described. The study assessed predictive factors of PMV after LT. METHODS: This observational, retrospective, monocentric study included all patients who received LT in Bichat Claude Bernard Hospital between January 2016 and December 2020. PMV was defined as a duration of MV > 14 days. Independent risk factors for PMV were studied using multivariate analysis. One-year survival depending on PMV was studied using Kaplan Meier and log-rank tests. A p value <0.05 was defined as significant. RESULTS: 224 LT recipients were analysed. 64 (28%) of them received PMV for a median duration of 34 [26–52] days versus 2 [1–3] days without PMV. Independent risk factors for PMV were higher body mass index (BMI) (p = 0.031), diabetes mellitus of the recipient (p = 0.039), ECMO support during surgery (p = 0.029) and intraoperative transfusion >5 red blood cell units (p < 0.001). Increased mortality rates were observed at one-year in recipients who received PMV (44% versus 15%, p < 0.001). CONCLUSION: PMV was associated with increased morbidity and mortality one-year after LT. Preoperative risk factors (BMI and diabetes mellitus) must be considered when selecting and conditioning the recipients. Frontiers Media S.A. 2023-05-09 /pmc/articles/PMC10203407/ /pubmed/37228395 http://dx.doi.org/10.3389/fmed.2023.1160621 Text en Copyright © 2023 Atchade, Boughaba, Dinh, Jean-Baptiste, Tanaka, Copelovici, Lortat-Jacob, Roussel, Castier, Messika, Mal, Tymowski and Montravers. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Atchade, Enora
Boughaba, Aimane
Dinh, Alexy Tran
Jean-Baptiste, Sylvain
Tanaka, Sébastien
Copelovici, Léa
Lortat-Jacob, Brice
Roussel, Arnaud
Castier, Yves
Messika, Jonathan
Mal, Hervé
de Tymowski, Christian
Montravers, Philippe
Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome
title Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome
title_full Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome
title_fullStr Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome
title_full_unstemmed Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome
title_short Prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome
title_sort prolonged mechanical ventilation after lung transplantation: risks factors and consequences on recipient outcome
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10203407/
https://www.ncbi.nlm.nih.gov/pubmed/37228395
http://dx.doi.org/10.3389/fmed.2023.1160621
work_keys_str_mv AT atchadeenora prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT boughabaaimane prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT dinhalexytran prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT jeanbaptistesylvain prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT tanakasebastien prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT copelovicilea prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT lortatjacobbrice prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT rousselarnaud prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT castieryves prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT messikajonathan prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT malherve prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT detymowskichristian prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome
AT montraversphilippe prolongedmechanicalventilationafterlungtransplantationrisksfactorsandconsequencesonrecipientoutcome