Etiologies and Outcomes of Acute Respiratory Failure in Solid Organ Transplant Recipients: Insight Into the EFRAIM Multicenter Cohort.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Messika Jonathan, Darmon Michael, Mal Hervé, Pickkers Peter, Soares Marcio, Canet Emmanuel, Rello Jordi, Bauer Philippe R, van de Louw Andry, Lemiale Virginie, Taccone Fabio Silvio, Loeches Ignacio Martin, Schellongowski Peter, Mehta Sangeeta, Antonelli Massimo, Kouatchet Achille, Barratt-Due Andreas, Valkonen Miia, Bruneel Fabrice, Pène Frédéric, Metaxa Victoria, Moreau Anne Sophie, Burghi Gaston, Montini Luca, Barbier François, Nielsen Lene B, Mokart Djamel, Chevret Sylvie, Zafrani Lara, Azoulay Elie, EFRAIM Investigators and the Nine-I Study Group
Аннотация
METHODS: In this post hoc analysis of an international cohort of immunocompromised patients admitted in the ICU for an acute respiratory failure, we analyzed all SOT recipients and compared their severity, etiologic diagnosis, prognosis, and outcome according to the performance of an invasive diagnostic strategy (encompassing a fiber-optic bronchoscopy and bronchoalveolar lavage), the type of transplanted organ, and the need of invasive ventilation at day 1.
RESULTS: Among 1611 patients included in the primary study, 142 were SOT recipients (kidney, n = 73; 51.4%; lung, n = 33; 23.2%; liver, n = 29; 20.4%; heart, n = 7; 4.9%). Lung transplant recipients were younger than other SOT recipients, and severity did not differ across type of received organ. An invasive diagnostic strategy was more frequently performed in lung transplant recipients with a trend toward a higher rate of bacterial etiology in lung than kidney transplant recipients. Overall ICU survival of SOT recipients was 75.4%. Invasive diagnostic strategy, type of transplanted organ, and need of invasive mechanical ventilation at day 1 did not affect ICU prognosis.
CONCLUSIONS: ICU management of hypoxemic acute respiratory failure in SOT recipients translated into a low ICU mortality rate, whatever the transplanted organ or the acute respiratory failure cause. The post-ICU burden of acute respiratory failure SOT recipients remains to be investigated.