Study objective: The aim was to identify potential predictors of ICU l
ength of stay (LOS) for single lung transplant patients. Design: Retro
spective chart review. Setting: University medical center. Patients: A
ll single lung transplant recipients for 1992 and 1993 at our institut
ion. Results: Data were collected from 69 patients. The median ICU LOS
was 5 days, and this was highly correlated with the duration of mecha
nical ventilation. The mean acute physiology and chronic health evalua
tion (APACHE II) score was 10. Patients with pulmonary hypertension ha
d the longest ICU LOS. Similarly, patients with a measured transpulmon
ary gradient of 20 mm Hg or less had a significantly shorter ICU LOS.
Patients with an immediate postoperative PaO2/fraction of inspired oxy
gen (FIo(2)) ratio greater than 200 mm Hg and a flow mismatch between
the two lungs of 30% or less also had a significantly shorter ICU LOS.
Positive and negative predictive values for the immediate postoperati
ve PaO2/FIo(2) ratio of 200 mm Hg or less mere 77% for an ICU LOS grea
ter than 5 days, and the calculated receiver operating characteristic
(ROC) curve area was 0.74. Conclusion: Overall, the immediate postoper
ative PaO2/FIo(2) ratio of 200 mm Hg or less had the best positive and
negative predictive values as well as the highest ROC curve area for
predicting an ICU LOS greater than 5 days.