TY - JOUR
T1 - ICU and Hospital Outcomes in Patients with Hepatopulmonary Syndrome Undergoing Liver Transplantation
AU - Aragon Pinto, Catarina
AU - Iyer, Vivek
AU - Almodallal, Yahya A.
AU - Albitar, Hasan
AU - Dubrock, Hilary
AU - Cajigas, Hector
AU - Heimbach, Julie K.
AU - Rosen, Charles B.
AU - Watt, Kimberly
AU - Taner, Timucin
AU - Nyberg, Scott
AU - Vargas, Hugo
AU - Cartin-Ceba, Rodrigo
AU - Keaveny, Andrew P.
AU - Krowka, Michael
AU - Gallo de Moraes, Alice
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/2
Y1 - 2022/2
N2 - Purpose: There are limited data regarding hospital and intensive care unit (ICU) outcomes in patients with hepatopulmonary syndrome (HPS) following liver transplantation (LT). Methods: Data were retrospectively collected from consecutive HPS adult patients who underwent LT and were immediately admitted to the ICU at three transplant centers with shared management protocols, from 2002 to 2018. Demographic, clinical, surgical, laboratory, and outcome data were extracted. Results: We identified 137 patients (74 male, 54%), with a median age at LT of 58 years (IQR: 52–63). One hundred and 31 (95.6%) patients were admitted to the ICU on invasive mechanical ventilation (MV). The median time on invasive MV in the ICU was 12 hours (IQR: 5–28) and 97 patients (74%) were extubated within 24 hours of ICU admission. The median highest positive end expiratory pressure and fraction of inspired oxygen (FiO2) were 7 (IQR: 5–8) and 0.6 (IQR: 0.5–0.7), respectively. 7 patients (5%) developed severe post-transplant hypoxemia. Of all patients, 42 (30.4%) required vasopressors and the median ICU and hospital length of stay (LOS) were 3 (IQR: 1–5) and 10 (IQR: 7–20) days, respectively. The in-hospital mortality rate was 3.6% (5/137). HPS severity was not associated with hospital mortality. Conclusion: Most HPS patients have short durations of MV, ICU, and hospital LOS post-LT. HPS severity does not impact hospital mortality.
AB - Purpose: There are limited data regarding hospital and intensive care unit (ICU) outcomes in patients with hepatopulmonary syndrome (HPS) following liver transplantation (LT). Methods: Data were retrospectively collected from consecutive HPS adult patients who underwent LT and were immediately admitted to the ICU at three transplant centers with shared management protocols, from 2002 to 2018. Demographic, clinical, surgical, laboratory, and outcome data were extracted. Results: We identified 137 patients (74 male, 54%), with a median age at LT of 58 years (IQR: 52–63). One hundred and 31 (95.6%) patients were admitted to the ICU on invasive mechanical ventilation (MV). The median time on invasive MV in the ICU was 12 hours (IQR: 5–28) and 97 patients (74%) were extubated within 24 hours of ICU admission. The median highest positive end expiratory pressure and fraction of inspired oxygen (FiO2) were 7 (IQR: 5–8) and 0.6 (IQR: 0.5–0.7), respectively. 7 patients (5%) developed severe post-transplant hypoxemia. Of all patients, 42 (30.4%) required vasopressors and the median ICU and hospital length of stay (LOS) were 3 (IQR: 1–5) and 10 (IQR: 7–20) days, respectively. The in-hospital mortality rate was 3.6% (5/137). HPS severity was not associated with hospital mortality. Conclusion: Most HPS patients have short durations of MV, ICU, and hospital LOS post-LT. HPS severity does not impact hospital mortality.
KW - Hepatopulmonary syndrome
KW - Intensive care unit
KW - Liver transplant
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U2 - 10.1007/s00408-021-00508-9
DO - 10.1007/s00408-021-00508-9
M3 - Article
C2 - 35013756
AN - SCOPUS:85122874742
SN - 0341-2040
VL - 200
SP - 5
EP - 10
JO - Pneumonologie. Pneumonology
JF - Pneumonologie. Pneumonology
IS - 1
ER -