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Titolo:
Acute pulmonary edema after lung transplantation - The pulmonary reimplantation response
Autore:
Khan, SU; Salloum, J; ODonovan, PB; Mascha, EJ; Mehta, AC; Matthay, MA; Arroliga, AC;
Indirizzi:
Cleveland Clin Fdn, Dept Pulm & Crit Care Med, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 re Med, Cleveland, OH 44195 USA Cleveland Clin Fdn, Dept Internal Med, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 al Med, Cleveland, OH 44195 USA Cleveland Clin Fdn, Dept Biostat, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 iostat, Cleveland, OH 44195 USA Cleveland Clin Fdn, Dept Radiol, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 Radiol, Cleveland, OH 44195 USA Univ Calif San Francisco, Inst Cardiovasc Res, San Francisco, CA 94143 USAUniv Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
CHEST
fascicolo: 1, volume: 116, anno: 1999,
pagine: 187 - 194
SICI:
0012-3692(199907)116:1<187:APEALT>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
ISCHEMIA-REPERFUSION INJURY; HYPERTENSION; DOGS;
Keywords:
acute pulmonary edema; lung transplantation; pulmonary reimplantation response;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Arroliga, AC Cleveland Clin Fdn, Dept Pulm & Crit Care Med, 9500 Euclid Ave,G62-156, Cleveland, OH 44195 USA Cleveland Clin Fdn 9500 Euclid Ave,G62-156 Cleveland OH USA 44195
Citazione:
S.U. Khan et al., "Acute pulmonary edema after lung transplantation - The pulmonary reimplantation response", CHEST, 116(1), 1999, pp. 187-194

Abstract

Background: Although the development of noncardiogenic pulmonary edema or pulmonary reimplantation response (PRR) after lung transplantation has beenwell described, the incidence has not been established and the relationship of PRR to clinical risk factors has not been analyzed. Study objectives: (1) To describe the incidence of PRR in lung transplant recipients, (2) to identify the predictors of PRR, (3) to examine the correlation of suspected predictors with the severity of PRR, and (4) to evaluate the impact of PRR on morbidity and mortality of lung transplant recipients. Design: Retrospective review of clinical records and radiographic studies. Setting: Tertiary care referral center. Patients: Ninety-nine consecutive patients with end-stage lung disease undergoing lung transplantation between February 1990 and October 1995 . Methods: Review of clinical records and postoperative chest radiographs ofall lung transplant recipients to identify patients who experienced PRR. Chest radiographs of patients with PRR were graded for severity on a scale of 0 (none) to 5 (very severe). Demographic, pre- and perioperative factors were also evaluated along with short- and long-term survival of patients with PRR. Results: Fifty-six of 99 lung transplant recipients (57%) experienced PRR. The median ischemia time of patients with and without PRR was 168 and 180 min, respectively (p = 0.62). The incidence of PRR was 51% in patients without preoperative pulmonary hypertension, 78% in mild to moderate pulmonary hypertension, and 58% in patients with severe pulmonary hypertension (p = 0.10). Incidence and severity of PRR was similar in patients receiving right, left, or double-lung transplantation. Similarly, age and sex of the recipients and underlying lung disease did not affect the incidence or severity of PRR. The incidence and severity of PRR was higher in patients undergoingcardiopulmonary bypass during lung transplantation, Patients with PRR had prolonged duration of mechanical ventilation and ICU stay. Overall, PRR didnot affect the survival of the patients. However, survival of female lung transplant recipients was significantly better than male recipients (mediansurvival, 60 vs 21 months; p = 0.02). Conclusions: Acute pulmonary edema or PRR occurs frequently (57%) after lung transplantation. In this series, PRR was not associated with a prolongedischemia time, preoperative pulmonary hypertension, the type of lung transplant, underlying lung disease, or age or sex of recipients. However, use of cardiopulmonary bypass during surgery was associated with increased incidence and severity of PRR. Also, the development of PRR resulted in prolonged mechanical ventilation and a longer ICU stay, but did not affect survival. Female lung transplant recipients survived significantly longer than malerecipients. The reason for this difference in survival is unclear.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 05:16:13