Predictors of long intensive care need after lung transplantation.

Eirik Olsen, Jul; Auråen, Henrik; T Durheim, Michael; E Fiane, Arnt; M Holm, Are

BACKGROUND While expected need for intensive care after lung transplantation (LTx) does not normally affect organ allocation, it would beuseful to estimate, particularly if intensive care capacity is limited. The aim of this study was to assess factorsavailable before LTxto identify predictors of prolonged intensive care unit (ICU) length of stay (LOS) after LTx. METHODS All bilateral LTx recipients excluding re-transplantation and multi-organ transplantation at Oslo University Hospitalfrom 2000-2013 were included (n=277). Predictive factors for ICULOS were identifiedusing pre- and perioperative variables. RESULTS Univariate analyses showed that recipients with pulmonary arterial hypertension, young age, female gender, low body height, low pretransplant actual total lung capacity (aTLC), and recipients who received an oversized donor lung were at risk for long ICU LOS. Patients with emphysema had lower risk of long ICU LOS. In multivariate analyses, a lower aTLC (P< 0.001) anda higher mean pulmonary artery pressure (mPAP) (P = 0.004)predicted prolonged ICU LOS. CONCLUSIONS We found that small recipient lung volume andhigh mPAP were predictors for prolonged ICU LOS.Our observations may be useful in planning use of resources in LTx, particularly in times of limited intensive care resources.