Gastroparesis Following Lung Transplantation: Risk Factor for Pneumonia
Background: Pneumonia in the postoperative period of lung transplantation (LT) increases early mortality. Gastroparesis following LT may be a risk factor for its occurrence.
Aims and Objectives: We aimed to evaluate if gastroparesis was a risk factor for pneumonia in a cohort of LT recipients. The impact of pneumonia on early mortality was also assessed.
Methods: We prospectively included 187 LT recipients admitted to the intensive care unit (ICU) in the immediate postoperative period. We defined gastroparesis as the presence of abdominal discomfort with enteral nutrition, gastric-content aspiration measured every 6h >500 mL and stomach dilation on chest x-ray. We followed the recommendations of the International Society of Heart and Lung Transplantation (ISHLT) for pneumonia definition. The follow-up period ended at one year. Continuous data are reported as median and interquartile range (IQR).
Results: Days of mechanical ventilation, in ICU and in hospital were 15 (30.5), 19 (31), 38 (33) respectively. 21 patients (11.2%) died in the ICU. Gastroparesis was present in 65 patients (34.8%) and it was associated with a higher risk of pneumonia (Odds ratio of 3.9, 95% confidence interval of 1.4ï¿½3.9). 22 patients (11.7%) suffered pneumonia and they had a higher mortality.
Conclusions: Gastroparesis is a risk factor for pneumonia in the postoperative period of LT and its prevention may decrease early mortality.