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 , Tymowski Christian de , Montravers Philippe 

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

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1160621

DOI=10.3389/fmed.2023.1160621

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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 &gt; 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 <italic>p</italic> value &lt;0.05 was defined as significant.</p></sec><sec><title>Results</title><p>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) (<italic>p</italic> = 0.031), diabetes mellitus of the recipient (<italic>p</italic> = 0.039), ECMO support during surgery (<italic>p</italic> = 0.029) and intraoperative transfusion &gt;5 red blood cell units (<italic>p</italic> &lt; 0.001). Increased mortality rates were observed at one-year in recipients who received PMV (44% versus 15%, <italic>p</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>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.</p></sec>