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Transplant Proc ; 44(9): 2663-5, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23146487

RESUMO

The postoperative period following lung transplantation remains critical because of several complications. Infection, primary graft failure, acute rejection, and surgical complications are risk factors for mortality and morbidity. The recognition and early treatment of these complications is important to optimize outcomes. This article provides an overview of postoperative complications observed in our center during the last year. We were particularly interested in the influence of variables, such as inotrope usage and Acute Physiology and Chronic Health Evaluation (APACHE II) score, a well-known, and validated mortality prediction model for general intensive care unit (ICU) patients only infrequently reported in the transplantation literature. High APACHE II scores were significantly associated with prolonged mechanical ventilation (P = 0.041) and a tracheostomy requirement (P = .035). The factors significantly associated with an early postoperative death were older donor age (P = .005), prolonged donor ICU period (P = .004), need for cardiopulmonary bypass (CB; P = .005), and high inotrope requirements in the ICU (P = .034). CB data were biased because we selected the worst case patients. Donor age and high inotrope requirements in the ICU have been reported previously to be prognostic factors for poor graft function. We believe that control of these variables may improve outcomes.


Assuntos
Hospitais Universitários , Unidades de Terapia Intensiva , Transplante de Pulmão/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , APACHE , Doença Aguda , Adulto , Fatores Etários , Cardiotônicos/uso terapêutico , Seleção do Doador , Feminino , Rejeição de Enxerto/epidemiologia , Humanos , Incidência , Transplante de Pulmão/mortalidade , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/terapia , Respiração Artificial , Fatores de Risco , Espanha/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Fatores de Tempo , Traqueostomia , Resultado do Tratamento
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