Efficacy of Recruitment Maneuver for Improving the Brain Dead Marginal Lungs to Ideal

Parto, S.; Shafaghi, Shadi; Khoddami-Vishteh, Hamid-Reza; Makki, Seyed Mohammad; Abbasi-Dezfuli, A.; Daneshvar, A; Sheikhy, Kambiz; Faeghi, J.; Ghorbani, Fariba; Parsa, Tahereh; Najafizadeh, K.

doi:10.1016/j.transproceed.2013.09.001

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…The use of pulmonary recruitment during retrieval is a common procedure. However, recruitment leads to the production of inflammatory mediators and pulmonary edema that may negatively affect the results of the transplant (28 –35). In our study, PEEP 2 animals presented more lesions and PEEP 5 presented focal septal thickening, possibly characterizing greater pulmonary injury compared to animals treated with PEEP 10.…”

Section: Discussionmentioning

confidence: 99%

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Gonçalves‐Ferri

Martins-Celini

Sansano

et al. 2019

Braz J Med Biol Res

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Atelectasis and inadequate oxygenation in lung donors is a common problem during the retrieval of these organs. Nevertheless, the use of high positive end-expiratory pressure (PEEP) is not habitual during procedures of lung retrieval. Twenty-one Sprague-Dawley male consanguineous rats were used in the study. The animals were divided into 3 groups according to the level of PEEP used: low (2 cmH 2 O), moderate (5 cmH 2 O), and high (10 cmH 2 O). Animals were ventilated with a tidal volume of 6 mL/kg. Before lung removal, the lungs were inspected for the presence of atelectasis. When atelectasis was detected, alveolar recruitment maneuvers were performed. Blood gasometric analysis was performed immediately. Finally, the lungs were retrieved, weighed, and submitted to histological analysis. The animals submitted to higher PEEP showed higher levels of oxygenation with the same tidal volumes PO 2 =262.14 (PEEP 2), 382.4 (PEEP 5), and 477.0 (PEEP 10). The occurrence of atelectasis was rare in animals with a PEEP of 10 cmH 2 O, which therefore required less frequent recruitment maneuvers (need for recruitment: PEEP 2=100%, PEEP 5 =100%, and PEEP 10=14.3%). There was no change in hemodynamic stability, occurrence of pulmonary edema, or other histological injuries with the use of high PEEP. The use of high PEEP (10 cmH 2 O) was feasible and probably a beneficial strategy for the prevention of atelectasis and the optimization of oxygenation during lung retrieval. Clinical studies should be performed to confirm this hypothesis.

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Section: Discussionmentioning

confidence: 99%

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Gonçalves‐Ferri

Martins-Celini

Sansano

et al. 2019

Braz J Med Biol Res

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“…In addition to lung-protective ventilation settings, pulmonary recruitment maneuvers may be initiated to optimize oxygenation in the DBD donor. By increasing transpulmonary pressure, recruitment maneuvers expand collapsed alveoli leading to the improved matching of ventilation and perfusion [ 67 ].…”

Section: Reviewmentioning

confidence: 99%

Anesthetic Considerations of Organ Procurement After Brain and Cardiac Death: A Narrative Review

Brown¹,

Abramowicz²,

Panzica³

et al. 2023

Cureus

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Organ donation procedures have become more frequent in the US as the need for transplants is increasing. Defining the anesthesiologist's role in organ donations after brain and cardiac death is important, as is understanding its ethics and practical physiologic and perioperative implications. Despite this, there are few papers specifically addressing the anesthetic management of organ donors. This review summarizes the preoperative, intraoperative, and postmortem considerations for the anesthesiologist involved in organ donation after either brain or cardiac death. A search of the published literature was performed using PubMed, Excerpta Medica dataBASE (EMBASE), and Google Scholar in March of 2022 for articles addressing anesthetic considerations of organ procurement surgeries after brain and cardiac death. This review demonstrates that anesthesiologists play a significant role in the organ procurement process. Their role in the perioperative management of the donor may affect the outcomes of organ transplantation. The gap between the number of organs harvested and the number of patients awaiting organ transplantation remains high despite continued efforts to increase the number of available organs. Perioperative management of organ donors aims at counteracting the associated unique physiologic derangements and targets optimization of oxygenation of the organs intended for procurement. Optimizing care after death can help ensure the viability of organs and the best outcomes for recipients. As organ donation after cardiac death (DCD) becomes more frequent in the US, anesthesiologists should be aware of the DCD classifications of donors and emerging novel perfusion techniques.

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“…Другой путь предполагает расширение критериев донора органов для трансплантации без ущерба для результатов трансплантации [7,8], а именно приме нение в рамках кондиционирования мультиорганного донора методов рекрутмента легких [9,10], исполь зование легких субоптимального донора с последу ющим проведением нормотермической экстракор поральной перфузии легких [11,12].…”

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Lung donation after cardiac arrest. Challenges and opportunities. Literature review

Pashkov,

Minina,

Grudinin

et al. 2024

RJTAO

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The global development of transplantology faces several objective obstacles. One of the major ones is widespread organ shortage. This is most pronounced in clinical lung transplantation (LT). The development of this area is directly connected with more intensive development of available donor resources and search for new sources of donor organs that are suitable for transplantation. Along with the existing methods of increasing the number of lungs suitable for transplantation, LT with donation after cardiac death (DCD) is attracting increasing attention. The effectiveness of this approach has been confirmed by the International Society for Heart and Lung Transplantation and deserves more attention from Russian specialists.

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Efficacy of Recruitment Maneuver for Improving the Brain Dead Marginal Lungs to Ideal

Cited by 5 publications

References 17 publications

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Analysis of different levels of positive end-expiratory pressure during lung retrieval for transplantation: an experimental study

Anesthetic Considerations of Organ Procurement After Brain and Cardiac Death: A Narrative Review

Lung donation after cardiac arrest. Challenges and opportunities. Literature review

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