The role of bronchoscopic lavage culture monitoring in affecting the length of stay in intensive care unit in lung transplant patients

INTRODUCTION: The aim of this study was to investigate whether bacterial growth detected in bronchial lavage is related to the length of stay in the intensive care unit (ICU).
METHODS: A single-center retrospective cohort study was conducted, including patients who underwent lung transplantation for end-stage lung disease at a tertiary hospital between January 2017 and December 2022. Data were collected from the hospital database, comprising 86 patients admitted to the ICU for at least 24 hours postoperatively. The study focused on the first 30 days in the ICU after transplantation. Seventeen patients were excluded due to early transfer to the ward, infection developed in the ward, intra-operative mortality, or missing data.
RESULTS: The final cohort consisted of 69 patients, with 81.2% male and a median age of 47 years (range: 32–56 years). The average waiting list duration was 3 months (range: 1–5 months). Among the patients, 44% had interstitial lung disease (ILD), followed by other conditions. Comorbidity indices showed that 30.4% had a score of 1, 46.4% had a score of 2, and 23.2% had a score of 3. No significant differences were detected in bronchoscopic lavage samples taken on days 0–3, 7, 14, and 30 post-transplantation. Additionally, bacterial culture positivity did not affect the length of stay in the ICU.
DISCUSSION AND CONCLUSION: Postoperative mortality is highest in the months following transplantation, primarily due to complications and infections. This study found no significant relationship between bacterial culture growth and ICU stay length, likely due to effective prophylactic antibiotic strategies and diligent patient monitoring. Further multicenter studies are needed to explore potential relationships between bacterial positivity and ICU stay duration.