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Abstract: Poster Presentations |

POST-OPERATIVE DELIRIUM IN LUNG TRANSPLANT RECIPIENTS: INCIDENCE AND ASSOCIATED RISK FACTORS AND MORBIDITY FREE TO VIEW

Jose F. Santacruz; Eduardo Mireles-Cabodevila, MD; Enrique Diaz Guzman Zavala, MD; Jose Diaz-Gomez, MD; Marie M. Budev, DO; Gosta Pettersson, MD; Alejandro C. Arroliga, MD
Author and Funding Information

Cleveland Clinic, University Heights, OH


Chest


Chest. 2009;136(4_MeetingAbstracts):18S. doi:10.1378/chest.136.4_MeetingAbstracts.18S-a
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Abstract

PURPOSE:  The incidence, risk factors and morbidity associated to post-operative delirium has not been described in lung transplant patients.

METHODS:  We conducted a prospective, observational, cohort study of patients that underwent lung transplantation. Delirium was diagnosed using the confusion assessment method for the intensive care unit (CAM-ICU) daily for a total of four days after lung transplant. Operative and post-operative hemodynamic and respiratory data was obtained, among several other critical illness parameters. Comparison was made for patients with delirium (D) and without delirium (ND).

RESULTS:  Between 07/06 and 09/07, 21 patients were enrolled. Twelve were females; and the mean age was 52 years (19–65). COPD was the most common indication for lung transplant, followed by IPF. By using the CAM-ICU, we found a 19% (4/21) incidence of delirium within 96hrs after transplant. Operatively, the D group had a higher mPAP (p = < 0.05) and MAP (p = 0.013). No difference in cardiac index, oxygenation, cardio-pulmonary bypass or surgical time was seen. The APACHE II score within the first 24hrs was higher in the D group (p = 0.0001). There was a trend towards a higher daily SOFA score in D patients. The time to extubation was higher in the D group when compare to the ND group (80.8hrs vs. 38hrs; p = 0.033). The tidal volume was larger in the D group within the first 24hrs (p = 0.05), while the partial pressure of arterial oxygen (PaO2) was not different. The length of hospital stay was similar among the groups.

CONCLUSION:  Delirium is common after lung transplantation. Patients with delirium had a higher post-operative APACHE II score, a trend towards a daily higher SOFA score. The length of mechanical ventilation and time to extubation was increased by the presence of delirium. The length of hospital stay was unchanged.

CLINICAL IMPLICATIONS:  Delirium in the post-operative period after lung transplantation increases the length of mechanical ventilation.

DISCLOSURE:  Jose Santacruz, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM


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