PDF(Pubmed)
Abstract：
OBJECTIVE: To investigate the association between driving pressure (ΔP) and 90-day mortality in patients following lung transplantation (LTx) in patients who developed primary graft dysfunction (PGD).
METHODS: This prospective, observational study involved consecutive patients who, following LTx, were admitted to our intensive care unit (ICU) from January 2022 to January 2023. Patients were separated into two groups according to ΔP at time of admission (i.e., low, ≤15 cmH2O or high, >15 cmH2O). Postoperative outcomes were compared between groups.
RESULTS: In total, 104 patients were involved in the study, and of these, 69 were included in the low ΔP group and 35 in the high ΔP group. Kaplan-Meier analysis of 90-day mortality showed a statistically significant difference between groups with survival better in the low ΔP group compared with the high ΔP group. According to Cox proportional regression model, the variables independently associated with 90-day mortality were ΔP and pneumonia. Significantly more patients in the high ΔP group than the low ΔP group had PGD grade 3 (PGD3), pneumonia, required tracheostomy, and had prolonged postoperative extracorporeal membrane oxygenation (ECMO) time, postoperative ventilator time, and ICU stay.
CONCLUSIONS: Driving pressure appears to have the ability to predict PGD3 and 90-day mortality of patients following LTx. Further studies are required to confirm our results.
METHODS: This prospective, observational study involved consecutive patients who, following LTx, were admitted to our intensive care unit (ICU) from January 2022 to January 2023. Patients were separated into two groups according to ΔP at time of admission (i.e., low, ≤15 cmH2O or high, >15 cmH2O). Postoperative outcomes were compared between groups.
RESULTS: In total, 104 patients were involved in the study, and of these, 69 were included in the low ΔP group and 35 in the high ΔP group. Kaplan-Meier analysis of 90-day mortality showed a statistically significant difference between groups with survival better in the low ΔP group compared with the high ΔP group. According to Cox proportional regression model, the variables independently associated with 90-day mortality were ΔP and pneumonia. Significantly more patients in the high ΔP group than the low ΔP group had PGD grade 3 (PGD3), pneumonia, required tracheostomy, and had prolonged postoperative extracorporeal membrane oxygenation (ECMO) time, postoperative ventilator time, and ICU stay.
CONCLUSIONS: Driving pressure appears to have the ability to predict PGD3 and 90-day mortality of patients following LTx. Further studies are required to confirm our results.
摘要：
目的：探讨肺移植（LTx）后发生原发性移植物功能障碍（PGD）的患者的驱动压（ΔP）与90天死亡率之间的关系。
方法：这种前瞻性，观察性研究涉及连续的患者，在LTx之后，于2022年1月至2023年1月入住我们的重症监护病房(ICU)。根据入院时的ΔP将患者分为两组(即，低,≤15cmH2O或高，>15cmH2O)。比较两组术后结果。
结果：总计，104名患者参与了这项研究，其中，低ΔP组中包括69个，高ΔP组中包括35个。90天死亡率的Kaplan-Meier分析显示，与高ΔP组相比，低ΔP组生存率较高的组之间存在统计学上的显着差异。根据Cox比例回归模型,与90天死亡率独立相关的变量为ΔP和肺炎.高ΔP组比低ΔP组明显更多的患者有PGD3级（PGD3），肺炎,需要气管造口术,术后体外膜氧合（ECMO）时间延长，术后呼吸机时间,ICU留下来。
结论：驱动压力似乎有能力预测LTx后患者的PGD3和90天死亡率。需要进一步的研究来证实我们的结果。
方法：这种前瞻性，观察性研究涉及连续的患者，在LTx之后，于2022年1月至2023年1月入住我们的重症监护病房(ICU)。根据入院时的ΔP将患者分为两组(即，低,≤15cmH2O或高，>15cmH2O)。比较两组术后结果。
结果：总计，104名患者参与了这项研究，其中，低ΔP组中包括69个，高ΔP组中包括35个。90天死亡率的Kaplan-Meier分析显示，与高ΔP组相比，低ΔP组生存率较高的组之间存在统计学上的显着差异。根据Cox比例回归模型,与90天死亡率独立相关的变量为ΔP和肺炎.高ΔP组比低ΔP组明显更多的患者有PGD3级（PGD3），肺炎,需要气管造口术,术后体外膜氧合（ECMO）时间延长，术后呼吸机时间,ICU留下来。
结论：驱动压力似乎有能力预测LTx后患者的PGD3和90天死亡率。需要进一步的研究来证实我们的结果。
