The incidence, risk factors and morbidity associated to post-operative delirium has not been described in lung transplant patients.
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).
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.
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.
Delirium in the post-operative period after lung transplantation increases the length of mechanical ventilation.
Jose Santacruz, No Financial Disclosure Information; No Product/Research Disclosure Information