Julien Fessler1,2, Jacques Thes3, Romain Pirracchio4,5, Mathieu Godement6,7, Edouard Sage2,8, Antoine Roux2,9, François Parquin2,8, Charles Cerf10, Marc Fischler1,2, Morgan Le Guen1,2. 1. Department of Anesthesiology, Hôpital Foch, Suresnes, France. 2. Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France. 3. Cardiothoracic Intensive Care Unit, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France. 4. Department of Anesthesiology and Intensive Care Medicine, Hôpital Européen Georges Pompidou, Paris, France. 5. Department of Biostatistics and of Medical Informatics, Inserm U1153, ECSTRA, Hôpital Saint Louis, Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 6. Department of Anesthesiology and Intensive Care Medicine, Hôpital Bichat, Paris, France. 7. Université Paris Diderot, Paris, France. 8. Department of Thoracic Surgery, Hôpital Foch, Suresnes, France. 9. Department of Pneumology, Hôpital Foch, Suresnes, France. 10. Department of Intensive Care Medicine, Hôpital Foch, Suresnes, France.
Abstract
INTRODUCTION: We evaluated the prognostic role of the arterial oxygen partial pressure/fractional inspired oxygen ratio (PaO2 /FiO2 ratio) measured at the end of double-lung transplantation (DLT). METHODS: This was a monocentric cohort study of all consecutive DLT patients between January 1, 2012, and January 1, 2016, except patients with preoperative extracorporeal membrane oxygenation (ECMO), intraoperative cardiopulmonary bypass, postoperative ECMO, large patent foramen ovale, redo transplantation during the study period, and multiorgan transplantation. RESULTS: A total of 164 patients were included in the study; 45 had a PaO2 /FiO2 ratio <200, 39 a ratio in the range 200-300, and 80 a ratio >300. The risk of being in the lower ratio group is positively related to body mass index, preoperative pulmonary hypertension, and fibrosis. It is negatively related to emergency surgery, age, and intraoperative institution of ECMO. There was a trend for more grade 3 pulmonary graft dysfunction at day 3 in the worst PaO2 /FiO2 ratio group. Mortality at 1000 days was similar for all patients and even after exclusion of patients who had required intraoperative ECMO. CONCLUSION: PaO2 /FiO2 ratio measured at the end of DLT does not forecast 1000-day mortality.
INTRODUCTION: We evaluated the prognostic role of the arterial oxygen partial pressure/fractional inspired oxygen ratio (PaO2 /FiO2 ratio) measured at the end of double-lung transplantation (DLT). METHODS: This was a monocentric cohort study of all consecutive DLT patients between January 1, 2012, and January 1, 2016, except patients with preoperative extracorporeal membrane oxygenation (ECMO), intraoperative cardiopulmonary bypass, postoperative ECMO, large patent foramen ovale, redo transplantation during the study period, and multiorgan transplantation. RESULTS: A total of 164 patients were included in the study; 45 had a PaO2 /FiO2 ratio <200, 39 a ratio in the range 200-300, and 80 a ratio >300. The risk of being in the lower ratio group is positively related to body mass index, preoperative pulmonary hypertension, and fibrosis. It is negatively related to emergency surgery, age, and intraoperative institution of ECMO. There was a trend for more grade 3 pulmonary graft dysfunction at day 3 in the worst PaO2 /FiO2 ratio group. Mortality at 1000 days was similar for all patients and even after exclusion of patients who had required intraoperative ECMO. CONCLUSION:PaO2 /FiO2 ratio measured at the end of DLT does not forecast 1000-day mortality.