| Autor: |
Lichtenstein, Gary R., Nunes, Frederick A., Lichtenstein, G R, Yang, Y X, Nunes, F A, Lewis, J D, Tuchman, M, Tino, G, Kaiser, L R, Palevsky, H I, Kotloff, R M, Furth, E E, Bavaria, J E, Stecker, M M, Kaplan, P, Berry, G T |
| Předmět: |
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| Zdroj: |
Annals of Internal Medicine; 02/15/2000, Vol. 132 Issue 4, p283-287, 5p, 1 Chart, 6 Graphs |
| Abstrakt: |
Background: A case of fatal hyperammonemia complicating orthotopic lung transplantation was previously reported.Objective: To describe the incidence, clinical features, and treatment of hyperammonemia associated with orthotopic lung transplantation.Design: Retrospective cohort analysis.Setting: Academic medical center and lung transplantation center in Philadelphia, Pennsylvania.Patients: 145 sequential adult patients who underwent orthotopic lung transplantation.Measurements: Plasma ammonium levels.Results: Six of the 145 patients who had had orthotopic lung transplantation developed hyperammonemia, all within the first 26 days after transplantation. The 30-day post-transplantation mortality rate was 67% for patients with hyperammonemia compared with 17% for those without hyperammonemia (P = 0.01). Development of major gastrointestinal complications (P = 0.03), use of total parenteral nutrition (P < 0.001), and lung transplantation for primary pulmonary hypertension (P = 0.045) were associated with hyperammonemia.Conclusions: Hyperammonemia is a potentially fatal event occurring after orthotopic lung transplantation. It is associated with high nitrogen load, concurrent medical stressors, primary pulmonary hypertension, and hepatic glutamine synthetase deficiency. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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