In the immediate postoperative period, the PDR is significantly correlated with the VRS. The pupillometer could be a valuable tool to guide morphine administration in the immediate postoperative period.

The applicability of the guidelines is questionable in many ways. The distinction between necrotizing/nonnecrotizing infections is valuable but difficult to apply prior to surgical management. The prescribers should choose a pragmatic approach to empirical antibiotic therapy, taking into account the patient's initial severity, the extent of infection and risk factors for resistant microorganisms essentially related to healthcare-associated circumstances.

BACKGROUND Acute kidney injury (AKI) is associated with increased short-term and long-term mortality and morbidity after lung transplantation (LT). The primary objective of this study was to analyze the perioperative factors associated with AKI according to KDIGO criteria during hospitalization in an intensive care unit (ICU) after LT. METHODS This was a single-center observational, prospective study. AKI was defined according to KDIGO criteria. Results are expressed as median, interquartile range, absolute numbers and percentages. Statistical analyses were performed using Chi-square test, Fisher's exact test and Mann-Witney U test (p<0.05 was considered to be significant). Multivariate analysis was performed to identify independent risk factors. RESULTS Between January 2016 and April 2018, 94 patients (pts) underwent LT (70% bilateral LT). AKI occurred during ICU stay in 46 pts (49%). KDIGO 1 AKI was observed in 16 pts (17%), KDIGO 2 in 14 pts (15%), and KDIGO 3 in 16 pts (17%) including 12 pts (75%) who required renal replacement therapy (RRT). AKI occurred before the fifth day after surgery for 38 patients (82% of the AKI patients). On multivariate analysis, independent factors associated with AKI were bilateral LT and mechanical ventilation (MV) > 3 days (OR 4.26 95%CI 1.49; 13.63 p=0.010 and OR 5.56 1.25; 11.47 p=0.018, respectively). AKI and the need for RRT were significantly associated with ICU mortality, 28-day mortality and one-year mortality. CONCLUSION AKI is common during ICU stay after LT, especially after bilateral LT and is associated with prolonged MV, and increased short-term and long-term mortality. Background Acute kidney injury (AKI) is a common complication after lung transplantation (LT), observed in 39 to 69% of LT recipients (1-4) and leading to renal replacement therapy (RRT) in 5 to 13% of cases (4,5).