ABSTRACT
Objective To investigate the risk factors of central airway stenosis after lung transplantation. Methods Clinical data of 155 recipients undergoing lung transplantation in Wuxi People's Hospital Affiliated to Nanjing Medical University from July 2016 to December 2017 were retrospectively analyzed. According to the incidence of central airway stenosis following lung transplantation, all recipients were divided into the stenosis group (n=36) and control group (n=119). The incidence of central airway stenosis after lung transplantation was summarized. The risk factors of central airway stenosis after lung transplantation were assessed by univariate and multivariate logistic regression analyses. Results Among 155 lung transplant recipients, 36 cases (23.2%) developed central airway stenosis. The average incidence time was (53±13) d after lung transplantation. Univariate analysis demonstrated that bilateral lung transplantation, grade 3 primary graft dysfunction (PGD), airway fungal infection, long cold ischemia time, long mechanical ventilation time and long intensive care unit (ICU) stay were the risk factors for central airway stenosis after lung transplantation (all P < 0.05). Multivariate analysis showed that airway fungal infection, long cold ischemia time and long mechanical ventilation time were the independent risk factors for central airway stenosis after lung transplantation (all P < 0.05). Conclusions Airway fungal infection after lung transplantation, long cold ischemia time and long mechanical ventilation time probably lead to central airway stenosis after lung transplantation. Active preventive measures and intimate monitoring should be taken to improve the quality of life of the recipients after lung transplantation.
ABSTRACT
Objective:To analyze the pulmonary function after pneumonia in children over 3 years old.Methods:This was an observational study recruiting children discharged from Beijing Children′s Hospital, Capital Medical University between January 1, 2016 and December 31, 2017 with the first diagnosis of pneumonia who were re-examined for pulmonary function within 0.5 to 2.0 years follow-up at outpatient department.Medical records during hospitalization, clinical information, pulmonary function and/or chest imaging examination were collected for analyzing lung function and relevant risk factors.Results:A total of 159 eligible patients who were followed up at the outpatient department were recruited, involving 100 patients receiving the lung function examination, and among them, 46 had abnormal lung function.There was no significant correlation between the gender and the pulmonary function after pneumonia ( χ2= 0.975, P=0.323). No correlation was found between the pulmonary function and pneumonia pathogens ( χ2=0.549, P=0.908). Children with severe pneumonia ( χ2=5.154, P=0.023) and abnormal chest imaging after pneumonia ( χ2=4.464, P=0.035) were more likely to have lung dysfunction.Among 74 children over 6 years old, there were 45 cases(60.81%) had pulmonary dysfunction after pneumonia, manifesting as the reduced forced expiration volume in one second (FEV 1), forced vital capacity (FVC), forced expiratory flow at 50% vital capacity, forced expiratory flow at 75% vital capacity, maximum mid-expiratory flow and FEV 1/FVC%. Conclusions:Lung dysfunction may occur after pneumonia, manifesting as small airway dysfunction, obstructive ventilation dysfunction and mixed ventilation dysfunction.The gender and etiology of pneumonia are not correlated with lung dysfunction after pneumonia.Children with severe pneumonia and continuous imaging abnormalities are more likely to have lung dysfunction.