移植物功能障碍是肺移植后急性呼吸衰竭的原因:四年多中心前瞻性研究153年成人需要重症监护承认JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.01512 -2018欧元六世- 54 - 3 SP - 1801512 AU梅佐Cristopher AU -桥,特蕾莎修女AU - Ballesteros玛丽亚·a . AU -洛佩兹Eloisa盟——Rellan Luzdivina AU -罗伯斯,胡安·c . AU - Rello我们的目的是评估成人肺移植患者重症监护室(ICU)再入院的主要原因，并确定ICU死亡率的独立预测因素(主要终点)。这项西班牙五中心前瞻性队列研究纳入了2012年至2016年间所有肺移植后重症监护室出院后再次入院的成人患者。随访患者直到出院或死亡。153名肺移植受者在移植后6(2-25)个月的中位(四分位数范围)出现174例ICU再入院。39例(25.5%)移植受者出现慢性肺异体移植物功能障碍，其中13例(全部出口)患有限制性异体移植物综合征(RAS)。急性呼吸衰竭(ARF)(110例(71.9%))是需要再入院治疗的主要病情。移植物排斥反应(6例(5.4%)急性)仅造成12例(10.8%)再入院，而肺炎(56例(36.6%))为主要原因(50例因ARF入院，6例因休克入院)，铜绿假单胞菌(50%多药耐药)为主要致病菌。在ICU死亡55例(35.9%)，在医院死亡69例(45.1%)。多因素分析发现，闭塞性毛细支气管炎综合征(BOS) 2期(调整OR (aOR) 7.2 (95% CI 1.0-65.7))、BOS 3期(aOR 13.7 (95% CI 2.5 - 95.3))、RAS (aOR 50)和再入院时的肺炎(aOR 2.5 (95% CI 1.0-7.1))是ICU死亡率的独立预测因素。 Only eight (5.2%) patients had positive donor-specific antibodies prior to ICU readmission and this variable did not affect the model.ARF was the main condition requiring ICU readmission in lung transplant recipients and was associated with high mortality. Pneumonia was the main cause of death and was also an independent predictor. RAS should receive palliative care rather than ICU admission.In lung transplant adults, pneumonia causes most ICU readmissions and independently influences risk of death, as chronic lung allograft dysfunction also does, particularly the restrictive phenotype. However, acute allograft dysfunction is far less common http://bit.ly/2Xvitv5 ER -