Postoperative organic mental syndromes in lung transplant recipients. Toronto Lung Transplant Group.

Delirium and other organic mental syndromes have frequently complicated the postoperative course of lung transplant recipients. A retrospective survey of 30 single-lung, double-lung, and heart-lung transplantations was undertaken to investigate the frequency of postoperative delirium, the responsible causative factors, and the efficacy of management strategies. Seventy-three percent of all recipients demonstrated an episode of delirium during their first 2 postoperative weeks. Undergoing cardiopulmonary bypass, having higher cyclosporine levels, and moving one's home from a distant location to await surgery were associated with an increased risk of postoperative delirium. A protocol that uses the intravenous administration of haloperidol has proved both effective and safe in the management of this frequently problematic complication.