Provider-Documented Dyspnea in Intensive Care Unit After Lung Transplantation |
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| Affiliation: | 1. Department of Intensive Care Unit, Kyoto University Hospital, Kyoto, Japan;2. Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan;3. Faculty of Nursing, Osaka Medical and Pharmaceutical University, Osaka, Japan;4. Department of Anesthesia, Kyoto University Hospital, Kyoto, Japan;1. Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada;2. Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada;1. Deakin University, IMPACT (Institute of Mental and Physical Health and Clinical Translation), Geelong, Australia;2. Barwon Health, Geelong, Australia;3. Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia;4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia;5. Deakin University, Faculty of Health, Biostatistics Unit, Geelong, Australia;6. Australian and New Zealand Intensive Care Research Centre (ANZIC-RC) Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia |
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| Abstract: | BackgroundDyspnea is an important problem that might affect the clinical course after lung transplantation; however, the prevalence, risk factors, and relevant outcomes of dyspnea in the intensive care unit (ICU) after lung transplantation remain unknown.MethodsThis retrospective, observational study enrolled consecutive patients aged ≥ 20 years who were admitted to the ICU after lung transplantation between January 2010 and December 2020. The main outcome measure was provider-documented dyspnea identified based on a comprehensive retrospective chart review to extract dyspnea episodes (e.g., documented words related to “dyspnea,” “shortness of breath,” or “breathlessness”).ResultsThis study included 184 lung transplant recipients, including 115 bilateral (63%) and 69 single (37%) lung transplants. Fifty-four transplants were from living donors (29%), and 130 were from deceased donors (71%). Dyspnea was documented in 116 patients (63%). Multivariate analysis identified bilateral lung transplantation (odds ratio = 5.127; 95% confidence interval, 2.020-13.014; P < .001) as a risk factor for dyspnea. In addition, postoperative anxiety (odds ratio = 18.605; 95% confidence interval, 7.748-44.674; P < .001) was independently associated with dyspnea. Patients with documented dyspnea showed delayed rehabilitation (P < .001) and weaning from mechanical ventilation (P < .001) and a longer ICU stay (P < .001).ConclusionThis study demonstrated that the prevalence of dyspnea in the ICU after lung transplantation was frequent and identified bilateral lung transplantation as a risk factor. Dyspnea caused a delay in rehabilitation and weaning from mechanical ventilation. Extensive evaluation and care for dyspnea and anxiety may enhance patient recovery. |
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