Contemporary trends in PGD incidence, outcomes, and therapies.
Contemporary trends in PGD incidence, outcomes, and therapies.
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DOI：
10.1016/j.healun.2022.08.013
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发表时间：
2022-12
影响因子：
8.9
通讯作者：
Christie, Jason D.
中科院分区：
文献类型：
--
作者：
Cantu, Edward;Diamond, Joshua M.;Cevasco, Marisa;Suzuki, Yoshi;Crespo, Maria;Clausen, Emily;Dallara, Laura;Ramon, Christian, V;Harmon, Michael T.;Bermudez, Christian;Benvenuto, Luke;Anderson, Michaela;Wille, Keith M.;Weinacker, Ann;Dhillon, Gundeep S.;Orens, Jonathan;Shah, Pali;Merlo, Christian;Lama, Vibha;McDyer, John;Snyder, Laurie;Palmer, Scott;Hartwig, Matt;Hage, Chadi A.;Singer, Jonathan;Calfee, Carolyn;Kukreja, Jasleen;Greenland, John R.;Ware, Lorraine B.;Localio, Russel;Hsu, Jesse;Gallop, Robert;Christie, Jason D.
关键词：
我们试图描述体外膜肺氧合（ECMO）的使用趋势，并确定对肺移植中PGD发生率和早期死亡率的影响。患者于2011年8月至2018年6月在多中心肺移植结局组前瞻性队列研究的10个移植中心入组。根据2016年PGD ISHLT指南，PGD定义为48或72小时的3级。使用逻辑回归和生存模型分别比较事件（即PGD和死亡）和至事件发生时间（即死亡、拔管、出院）结局的组效应。两种建模框架均包含潜在混杂因素。入组了1，528例受试者，PGD发生率为25.7%。在研究过程中，PGD年发病率（14.3%至38.2%，p=0.0002）、中位LAS（38.0至47.7，p=0.009）和使用ECMO挽救PGD（5.7%至20.9%，p=0.007）增加。PGD与1年死亡率增加相关（OR 1.7 [95% CI]）。1.2，2.3]，p=0.0001）。与非桥接患者相比，桥接策略与死亡率增加无关（p=0.66）;然而，补救ECMO治疗PGD与死亡率增加显著相关（OR 1.9 [1.3，2.7]，p=0.0007）。1年时的限制性平均生存时间比较表明，与未接受PGD的受者相比，接受PGD的静脉动脉挽救受者损失了84.1天（比值1.3 [1.1，1.5]），接受PGD的静脉静脉挽救受者损失了27.2天（比值1.1 [1.0，1.4]）。在现代移植实践中，由于受者疾病严重程度的显著增加，PGD发病率继续上升。桥接策略增加，但不影响PGD的发病率或死亡率。PGD仍然与死亡率高度相关，并且越来越多地采用补救ECMO治疗。
We sought to describe trends in extracorporeal membrane oxygenation (ECMO) use, and define the impact on PGD incidence and early mortality in lung transplantation. Patients were enrolled from August 2011 to June 2018 at 10 transplant centers in the multi-center Lung Transplant Outcomes Group prospective cohort study. PGD was defined as Grade 3 at 48 or 72 hours, based on the 2016 PGD ISHLT guidelines. Logistic regression and survival models were used to contrast between group effects for event (i.e. PGD and Death) and time-to-event (i.e. death, extubation, discharge) outcomes respectively. Both modeling frameworks accommodate the inclusion of potential confounders. 1,528 subjects were enrolled with a 25.7% incidence of PGD. Annual PGD incidence (14.3% to 38.2%, p=0.0002), median LAS (38.0 to 47.7 p=0.009) and the use of ECMO salvage for PGD (5.7% to 20.9%, p=0.007) increased over the course of the study. PGD was associated with increased 1-year mortality (OR 1.7 [95% C.I. 1.2, 2.3], p=0.0001). Bridging strategies were not associated with increased mortality compared to non-bridged patients (p=0.66); however, salvage ECMO for PGD was significantly associated with increased mortality (OR 1.9 [1.3, 2.7], p=0.0007). Restricted mean survival time comparison at 1-year demonstrated 84.1 days lost in venoarterial salvaged recipients with PGD when compared to those without PGD (ratio 1.3 [1.1, 1.5]) and 27.2 days for venovenous with PGD (ratio 1.1 [1.0, 1.4]). PGD incidence continues to rise in modern transplant practice paralleled by significant increases in recipient severity of illness. Bridging strategies have increased but did not affect PGD incidence or mortality. PGD remains highly associated with mortality and is increasingly treated with salvage ECMO.
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影响因子：
9.6
作者：
Crotti, Stefania;Iotti, Giorgio A.;Gattinoni, Luciano
通讯作者：
Gattinoni, Luciano
影响因子：
5.7
作者：
Abrams, Darryl;Brodie, Daniel;Arcasoy, Selim M.
通讯作者：
Arcasoy, Selim M.
DOI：
10.1016/j.jtcvs.2017.09.161
发表时间：
2018-03-01
影响因子：
6
作者：
Hoetzenecker, Konrad;Donahoe, Laura;Cypel, Marcelo
通讯作者：
Cypel, Marcelo
DOI：
10.1164/rccm.200409-1243oc
发表时间：
2005-06-01
影响因子：
24.7
作者：
Christie, JD;Kotloff, RM;Kimmel, SE
通讯作者：
Kimmel, SE
影响因子：
4.6
作者：
Biscotti, Mauer;Gannon, Whitney D.;Bacchetta, Matthew
通讯作者：
Bacchetta, Matthew