Intraoperative Hypoxia Independently Associated With the Development of Acute Kidney Injury Following Bilateral Orthotopic Lung Transplantation.

Background Acute kidney injury (AKI) is a common postoperative complication in bilateral orthotopic lung transplant (BOLTx) recipients, but the contribution of intraoperative variables is not well defined. The authors hypothesized that intraoperative hypotension as well as hypoxia and vasopressor use would be associated with the development of postoperative AKI after BOLTx in patients without preexisting renal dysfunction. Methods The authors performed a retrospective analysis of patients undergoing BOLTx at a single center between 2013-2017. Intraoperative variables of hemodynamics included duration of mean arterial pressure (MAP) Results AKI occurred in 177 (72%) of 245 patients in postoperative day 1-7. Notable significant differences in univariate analyses included cumulative mechanical support time, maximum VIS, peripheral oxygen saturation 15 minutes, total minutes oxygen saturation 15 minutes for MAP 15 minutes to be independently associated with AKI. Conclusions This study revealed that >15 minutes of intraoperative hypoxia was independently associated with postoperative AKI after BOLTx.Supplemental Visual Abstract; http://links.lww.com/TP/C226.