EN in critically ill patients with severe hypoxemia receiving mechanical ventilation in PP is feasible, safe, and not associated with an increased risk of gastrointestinal complications. Larger studies are needed to confirm these findings.
Purpose
We examined the ability of the P(v‐a)CO2/Da‐vO2 ratio combined with elevated lactate levels to predict early allograft dysfunction (EAD).
Materials and methods
Patients were classified into four groups according to lactate levels and P(v‐a)CO2/Da‐vO2 ratio: Group 1; lactate >2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio >1.0; Group 2; lactate >2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio <1.0; group 3; lactate<2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio >1.0; group 4; lactate<2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio <1.0. We defined EAD according to Olthoff criteria.
Results
One‐hundred and fifty patients were included. EAD occurred in 41 patients (27.3%), and was associated with worse graft survival at 1 year (92% vs. 73%; P = ,003) as well as a higher re‐transplantation rate (4,6% vs. 17,1%; P = ,019). The multivariate analysis revealed that P(v‐a)CO2/Da‐vO2 ratio at T6 [OR 7.05(CI95% 2.77–19.01, P<.001)] was an independent predictor for EAD. Belonging to group 1 at 6 h was associated with worse clinical outcomes but no association was found with 1‐year graft survival or 1‐year patient survival.
Conclusions
In this single center, prospective, observational study in patients who received an OLT, we found that elevated lactate levels combined with a high Cv‐aCO2/Da‐vO2 after 6 h was associated with the development of EAD and worse clinical outcomes in the early postoperative period.
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