May 31, 2020

Acute respiratory failure among lung transplant adults requiring intensive care: Changing spectrum of causative organisms and impact of procalcitonin test in the diagnostic work up

Transplant Infectious Disease : an Official Journal of the Transplantation Society
Sofía TejadaJordi Rello

Abstract

The aim was to identify the causing organisms and assess the association of procalcitonin (PCT) with bacterial pneumonia within 24-hours of intensive care unit admission (ICU-A) among lung transplant (LT) adult recipients. Secondary analysis from a prospective cohort study. All LT adults admitted to ICU for acute respiratory failure (ARF) over five years were included. Patients were followed until hospital discharge or death. Fifty-eight consecutive LT patients were enrolled. The most important cause of ICU-A due to ARF was pneumonia 29 (50.0%) followed by acute rejection 3 (5.2%), and bronchiolitis obliterans syndrome exacerbation 3 (5.2%). Microorganisms were isolated from 22/29 cases with pneumonia (75.9%): 17 (77.2%) bacterial, 4 (18.2%) viral, 1 (4.5%) Aspergillus fumigates, with Pseudomonas aeruginosa being the most common cause (45.5%) of pneumonia, with 10 patients presenting chronic colonization by P. aeruginosa. Median [Interquartile range (IQR)] PCT levels within 24-hours after admission were higher in pneumonia (1.5µg/L; IQR:0.3-22.0), than in non-pneumonia cases (0.2µg/L; IQR:0.1-0.7) (p=0.019) and PCT levels within 24-hours helped to discriminate bacterial pneumonia (8.2µg/L; IQR:0.2-43.0) from viral pneumonia and...Continue Reading

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Mentioned in this Paper

Respiratory viruses
Intensive Care Unit
Pneumonia, Viral
Cessation of Life
Prospective Cohort Study
Pneumonia
Analysis
Diagnosis
Hospital Admission
Pseudomonas aeruginosa

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