PT - JOURNAL ARTICLE AU - Mazo, christopher AU - Pont, Teresa AU - Ballesteros, Maria A. AU - López, Eloísa AU - Rellán, Luzdivina AU - Robles, Juan C. AU - Rello, Jordi TI -肺炎 vs 移植物功能障碍作为肺移植后急性呼吸衰竭的原因:AID - 10.1183/13993003.01512-2018 DP - 2019 9月01日TA -欧洲呼吸杂志PG - 1801512 VI - 54 IP - 3 4099 - //www.qdcxjkg.com/content/54/3/1801512.short 4100 - //www.qdcxjkg.com/content/54/3/1801512.full SO - Eur Respir J2019 9月01日;54 AB -我们旨在评估肺移植成人重症监护病房(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招募了2012年至2016年间所有移植后出院后再入院的肺移植成人。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)个月的中位数(四分位数范围)中有174例再入院。39例(25.5%)受者报告慢性肺异体移植功能障碍，其中13例(所有出口)患有限制性异体移植综合征(RAS)。急性呼吸衰竭(ARF) 110例(71.9%)是需要再入院的主要情况。移植排斥反应(6例(5.4%)急性)仅导致12例(10.8%)再入院，而肺炎(56例(36.6%)是主要原因(50例因急性肾功能衰竭入院，6例因休克入院)，铜绿假单胞菌(50%多药耐药)是主要病原体。重症监护室死亡55例(35.9%)，医院死亡69例(45.1%)。在多因素分析中，闭塞性细支气管炎综合征(BOS) 2期(调整后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ICU再入院时肺炎(aOR 2.5 (95% CI 1.0-7.1))被确定为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