Bicarbonate in Arteries Measured Preoperatively for Cadaveric Single-lung Transplantation is Related to Intraoperative Extra-Corporeal Membrane Oxygenation Use: A Retrospective Preliminary Study

N. Kobayashi, H. Toyama, R. Kubo, Y. Matsuda, Y. Okada, Y. Ejima, M. Yamauchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There are no known predictors of extracorporeal membrane oxygenation (ECMO) induction for single lung transplantation. Objective: The purpose of the present study was to clarify the relationship between variables and ECMO requirements in single lung transplantation. Methods: This study included adult patients who underwent cadaveric single lung transplantation between 2010 and 2019. After general anesthesia, the transplanted lungs were ventilated in all cases. The analysis included 38 patients in the ECMO required (RQ) group and 12 patients in the ECMO non-required (FR) group. Comparisons were made between the two groups for data affecting ECMO implementation, and data that were significantly different were subjected to multivariate analysis. Results: Prior to anesthesia, the bicarbonate (HCO3-) value of the FR group was lower than that of the RQ group (24.6±2.7 vs. 29.7±5.3 mmol/L, p=0.005). Multivariate analysis showed that the cut-off bicarbonate value was 29.6. The area under the receiver operating characteristic curve (AUROC) of the model was 0.869 (R2: 0.331), with a sensitivity of 79% and a specificity of 88%. The odds ratio was 1.63 for every unit increase in the bicarbonate value (95%CI: 1.11-2.39, p<0.001). Further, the FR group had higher arterial blood pressure (mean: 79.0±11.5 vs. 68.9±8.3 mmHg, p=0.030), less blood loss (432±385 vs. 1,623±1,997 g, p<0.001), shorter operation time (417±44 vs. 543±111 min, p<0.001), and shorter ICU stay (11±9 vs. 25±38 days, p=0.039). Conclusion: Preoperative evaluation of bicarbonate could predict the need for ECMO for single lung transplantation

Original languageEnglish
Pages (from-to)36-42
Number of pages7
JournalInternational Journal of Organ Transplantation Medicine
Volume12
Issue number4
Publication statusPublished - 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Transplantation

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