Prospective validation of right ventricular role in primary graft dysfunction after lung transplantation
| Autor: | Joaquim Gea, J. Serra, J F Rodriguez-Palomares, Oriol Roca, A. Zapatero, Purificación Pérez-Terán, Arturo Evangelista, Juan Carlos Ruiz-Rodríguez, Joan R. Masclans |
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| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Heart Ventricles medicine.medical_treatment Cardiac index Primary Graft Dysfunction 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Lung transplantation Prospective Studies Risk factor Prospective cohort study Lung Aged business.industry Pulmonary artery catheter Middle Aged Surgery Transplantation Logistic Models medicine.anatomical_structure ROC Curve 030228 respiratory system Echocardiography Spain Multivariate Analysis Ventricular Function Right Female business Pulmons -- Trasplantació Lung Transplantation |
| Zdroj: | Recercat. Dipósit de la Recerca de Catalunya instname |
| Popis: | Primary graft dysfunction is a significant cause of lung transplant morbidity and mortality, but its underlying mechanisms are not completely understood. The aims of the present study were: 1) to confirm that right ventricular function is a risk factor for severe primary graft dysfunction; and 2) to propose a clinical model for predicting the development of severe primary graft dysfunction.A prospective cohort study was performed over 14 months. The primary outcome was development of primary graft dysfunction grade 3. An echocardiogram was performed immediately before transplantation, measuring conventional and speckle-tracking parameters. Pulmonary artery catheter data were also measured. A classification and regression tree was made to identify prognostic models for the development of severe graft dysfunction.70 lung transplant recipients were included. Patients who developed severe primary graft dysfunction had better right ventricular function, as estimated by cardiac index (3.5±0.8 versus 2.6±0.7 L·min−1·m−2, pversus −19.5±6.6%, pBetter right ventricular function is a risk factor for the development of severe primary graft dysfunction. Preoperative estimation of right ventricular function could allow early identification of recipients at increased risk, who would benefit the most from careful perioperative management in order to limit pulmonary overflow. |
| Databáze: | OpenAIRE |
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