A prospective evaluation of phrenic nerve injury after lung transplantation: Incidence, risk factors, and analysis of the surgical procedure

Hernández-Hernández, Miguel A.; Sánchez-Moreno, Laura; Orizaola, Pedro; Iturbe-Fernández, David; Álvaréz, Carlos; Fernández-Rozas, Sonia; González-Novoa, Vanesa; Llorca, Javier; Hernández, José L.; Fernández‐Torre, José L.; Parra, José Antonio

doi:10.1016/j.healun.2021.09.013

Cited by 12 publications

(26 citation statements)

References 36 publications

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“…Another potential risk factor is that the intraoperative amount of red blood cell (RBC) transfusion was also not confirmed in the present study, while it was identified as independent risk factors for TT in a population of patients undergoing acute type A aortic dissection surgery and lung transplant [12,13].…”

Section: Discussioncontrasting

confidence: 58%

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Advanced Respiratory Failure Requiring Tracheostomy—A Marker of Unfavourable Prognosis after Heart Transplantation

Załęska-Kocięcka,

Morosin,

Dutton

et al. 2024

Diagnostics

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Advanced respiratory failure with tracheostomy requirement is common in heart recipients. The aim of the study is to assess the tracheostomy rate after orthotopic heart transplantation and identify the subgroups of patients with the highest need for tracheostomy and these groups’ association with mortality at a single centre through a retrospective analysis of 140 consecutive patients transplanted between December 2012 and July 2018. As many as 28.6% heart recipients suffered from advanced respiratory failure with a need for tracheostomy that was performed after a median time of 11.5 days post-transplant. Tracheostomy was associated with a history of stroke (OR 3.4; 95% CI) 1.32–8.86; p = 0.012), previous sternotomy (OR 2.5; 95% CI 1.18–5.32; p = 0.017), longer cardiopulmonary bypass time (OR 1.01; 95% CI 1.00–1.01; p = 0.007) as well as primary graft failure (OR 6.79; 95% CI2.93–15.71; p < 0.001), need of renal replacement therapy (OR 19.2; 95% 2.53–146; p = 0.004) and daily mean SOFA score up to 72 h (OR 1.50; 95% 1.23–1.71; p < 0.01). One-year mortality was significantly higher in patients requiring a tracheostomy vs. those not requiring one during their hospital stay (50% vs. 16%, p < 0.001). The need for tracheostomy in heart transplant recipients was 30% in our study. Advanced respiratory failure was associated with over 3-fold greater 1-year mortality. Thus, tracheostomy placement may be regarded as a marker of unfavourable prognosis.

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Section: Discussioncontrasting

confidence: 58%

“…Unfortunately, other potential risk factors were missed, for instance, phrenic nerve palsy. This complication is common in lung transplant recipients and is associated with prolonged mechanical ventilation and increased morbidity [12]. Interestingly, it is a potentially curable condition with diaphragm pacing [14].…”

Section: Discussionmentioning

confidence: 99%

Advanced Respiratory Failure Requiring Tracheostomy—A Marker of Unfavourable Prognosis after Heart Transplantation

Załęska-Kocięcka,

Morosin,

Dutton

et al. 2024

Diagnostics

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“…Previous studies have reported that recipient obesity was an independent risk factor for PGD3 and was also associated with lower 90-day survival 15 . Prolonged operative time may affect the following aspects: prolonged cold ischemia of the donor lung may cause increased graft rejection 16 ; prolonged anesthesia increases the risk of respiratory muscle weakness and slower recovery of anesthesia 17 ; there is an increased chance of infection of the lungs with mechanical ventilation during surgery 18 . Intraoperative use of ECMO has several advantages including achieve lung-protective ventilation strategy, effectively reduce pulmonary blood flow, and provide hemodynamic stabilization.…”

Section: Discussionmentioning

confidence: 99%

A novel nomogram for predicting prolonged mechanical ventilation in lung transplantation patients using extracorporeal membrane oxygenation

Xuan,

Gu,

et al. 2024

Sci Rep

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Prolonged mechanical ventilation (PMV) is commonly associated with increased post-operative complications and mortality. Nevertheless, the predictive factors of PMV after lung transplantation (LTx) using extracorporeal membrane oxygenation (ECMO) as a bridge remain unclear. The present study aimed to develop a novel nomogram for PMV prediction in patients using ECMO as a bridge to LTx. A total of 173 patients who used ECMO as a bridge following LTx from January 2022 to June 2023 were divided into the training (122) and validation sets (52). A mechanical ventilation density plot of patients after LTx was then performed. The training set was divided in two groups, namely PMV (95) and non-prolonged ventilation (NPMV) (27). For the survival analysis, the effect of PMV was assessed using the log-rank test. Univariate and multivariate logistic regression analyses were performed to assess factors associated with PMV. A risk nomogram was established based on the multivariate analysis, and model performance was further assessed in terms of calibration, discrimination, and clinical usefulness. Internal validation was additionally conducted. The difference in survival curves in PMV and NPMV groups was statistically significant (P < 0.001). The multivariate analysis and risk factors in the nomogram revealed four factors to be significantly associated with PMV, namely the body mass index (BMI), operation time, lactic acid at T0 (Lac), and driving pressure (DP) at T0. These four factors were used to develop a nomogram, with an area under the curve (AUC) of 0.852 and good calibration. After internal validation, AUC was 0.789 with good calibration. Furthermore, goodness-of-fit test and decision-curve analysis (DCA) indicated satisfactory performance in the training and internal validation sets. The proposed nomogram can reliably and accurately predict the risk of patients to develop PMV after LTx using ECMO as a bridge. Four modifiable factors including BMI, operation time, Lac, and DP were optimized, which may guide preventative measures and improve prognosis.

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“…Wang et al found that the EIT may be a useful adjunctive tool for evaluating ventilator weaning using pre-SBT GI and SBT ROI 2 (four ROIs were divided from the ventral to dorsal, with ROI 2 being the second region) as predictors (Wang et al, 2021). In addition to weaning failure due to pulmonary system dysfunction, phrenic nerve injury can also lead to atelectasis, difficult weaning, and prolonged ventilation in lung transplantation (Hernández-Hernández et al, 2022). Moon et al (2021) revealed that dynamic inhomogeneity of ventilation along the vertical axis of lungs using EIT could predict weaning failure regardless of diaphragm dysfunction.…”

Section: Weaningmentioning

confidence: 99%

Imaging and Functional Imaging of the Lung

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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A prospective evaluation of phrenic nerve injury after lung transplantation: Incidence, risk factors, and analysis of the surgical procedure

Cited by 12 publications

References 36 publications

Advanced Respiratory Failure Requiring Tracheostomy—A Marker of Unfavourable Prognosis after Heart Transplantation

Advanced Respiratory Failure Requiring Tracheostomy—A Marker of Unfavourable Prognosis after Heart Transplantation

A novel nomogram for predicting prolonged mechanical ventilation in lung transplantation patients using extracorporeal membrane oxygenation

Imaging and Functional Imaging of the Lung

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