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. 2018 Mar 5;18(1):43.
doi: 10.1186/s12890-018-0605-9.

Morbidity and mortality related to pneumonia and TRACHEOBRONCHITIS in ICU after lung transplantation

Sebastien Tanaka  1 , Claire Geneve  2 , Gianpiero Tebano  2 , Nathalie Grall  3   4   5 , Pascal Piednoir  2 , Régis Bronchard  2 , Mathieu Godement  2 , Enora Atchade  2 , Pascal Augustin  2 , Herve Mal  3   6   7 , Yves Castier  3   7   8 , Philippe Montravers  2   3   7 , Mathieu Desmard  2   9
Affiliations

Morbidity and mortality related to pneumonia and TRACHEOBRONCHITIS in ICU after lung transplantation

Sebastien Tanaka et al. BMC Pulm Med. .

Abstract

Background: Bacterial respiratory infections (BRI) are major complications contributing to increased morbidity and mortality after lung transplantation (LT). This study analyzed epidemiology and outcome of 175 consecutive patients developing BRI in ICU after LT between 2006 and 2012.

Methods: Three situations were described: colonization determined in donors and recipients, pneumonia and tracheobronchitis during the first 28 postoperative days. Severity score, demographic, bacteriologic and outcome data were collected.

Results: 26% of donors and 31% of recipients were colonized. 92% of recipients developed BRI, including at least one episode of pneumonia in 19% of recipients. Only 21% of recipients developed BRI with an organism cultured from the donor's samples, while 40% of recipients developed BRI with their own bacteria cultured before LT. Purulent sputum appears to be an important factor to discriminate tracheobronchitis from pneumonia. When compared to patients with tracheobronchitis, those with pneumonia had longer durations of mechanical ventilation (13 [3-27] vs 3 [29], p = 0.0005) and ICU stay (24 [16-34] vs 14 [9-22], p = 0.002). Pneumonia was associated with higher 28-day (11 (32%) vs 9 (7%), p = 0.0004) and one-year mortality rates (21 (61%) vs 24 (19%), p ≤ 0.0001).

Conclusions: These data confirm the high frequency of BRI right from the early postoperative period and the poor prognosis of pneumonia after LT.

Keywords: Bronchitis; ICU; Lung transplantation; Mortality; Pneumonia.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Paris North Hospitals Institutional Review Board (Paris VII University, AP-HP, IRB No. 00006477). According to French law, no informed consent was required in view of the observational and retrospective nature of this study.

Consent for publication

Not applicable.

Competing interests

The authors declared that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Relationship between pneumonia and recipient-donor colonization
Fig. 2
Fig. 2
Time-course of episodes of pneumonia (n = 42)
Fig. 3
Fig. 3
Kaplan-Meier graph of 1-year survival of patients with tracheobronchitis and pneumonia (p<0.0001 by log rank test)
See this image and copyright information in PMC

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