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Predictors of long intensive care need after lung transplantation
Author(s) -
Olsen Jul Eirik,
Auråen Henrik,
Durheim Michael T.,
Fiane Arnt E.,
Holm Are M.
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14152
Subject(s) - medicine , intensive care unit , intensive care , lung transplantation , perioperative , transplantation , univariate analysis , lung , intensive care medicine , multivariate analysis , emergency medicine , surgery
Background While expected need for intensive care after lung transplantation (LTx) does not normally affect organ allocation, it would be useful to estimate whether intensive care capacity is limited. The aim of this study was to assess factors available before LTx to identify predictors of prolonged intensive care unit (ICU) length of stay (LOS) after LTx. Methods All bilateral LTx recipients excluding re‐transplantation and multi‐organ transplantation at Oslo University Hospital from 2000 to 2013 were included ( n = 277). Predictive factors for ICU LOS were identified using pre‐ and perioperative variables. Results Univariate analyses showed that recipients with pulmonary arterial hypertension, young age, female gender, low body height, low pretransplant actual total lung capacity (aTLC), and recipients who received an oversized donor lung were at risk for long ICU LOS. Patients with emphysema had lower risk of long ICU LOS. In multivariate analyses, a lower aTLC ( p < .001) and a higher mean pulmonary artery pressure (mPAP) ( p = .004) predicted prolonged ICU LOS. Conclusions We found that small recipient lung volume and high mPAP were predictors for prolonged ICU LOS. Our observations may be useful in planning use of resources in LTx, particularly in times of limited intensive care resources.