Lung Transplantation

Roscoe, Andrew

doi:10.1007/978-1-4419-0184-2_37

Cited by 2 publications

(3 citation statements)

References 157 publications

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“…There were no significant differences between control and alveolar recruitment groups in median (IQR [range]) ICU length of stay (6 (3–23 [2–124]) days vs. 4 (2–8 ) days, p = 0.46) or hospital length of stay (28 (21–37 [16–128]) days vs. 21 (14–24 [13–65] days), p = 0.26). All of the patients involved in the study survived at least 30 days.…”

Section: Resultsmentioning

confidence: 99%

“…No standardised approach to ventilatory management exists in lung transplantation . Recent reviews have suggested that some protective benefit may be realised from low tidal volume ventilation, possibly with pressure‐controlled ventilator modes, higher positive end‐expiratory pressure (PEEP) and step‐wise alveolar recruitment manoeuvres .…”

Section: Introductionmentioning

confidence: 99%

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Intra‐operative protective mechanical ventilation in lung transplantation: a randomised, controlled trial

et al. 2017

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Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml.kg , one-lung ventilation 4 ml.kg )) or an alveolar recruitment group (regular step-wise positive end-expiratory pressure-based alveolar recruitment manoeuvres, pressure-controlled ventilation set at 16 cmH O with 10 cmH O positive end-expiratory pressure). Ventilation strategies were commenced from reperfusion of the first lung allograft and continued for the duration of surgery. Regular PaO /F O ratios were calculated and venous blood samples collected for inflammatory marker evaluation during the procedure and for the first 24 h of intensive care stay. The primary end-point was the PaO /F O ratio at 24 h after first lung reperfusion. Thirty adult patients were studied. The primary outcome was not different between groups (mean (SD) PaO /F O ratio control group 340 (111) vs. alveolar recruitment group 404 (153); adjusted p = 0.26). Patients in the control group had poorer mean (SD) PaO /F O ratios at the end of the surgical procedure and a longer median (IQR [range]) time to tracheal extubation compared with the alveolar recruitment group (308 (144) vs. 402 (154) (p = 0.03) and 18 (10-27 [5-468]) h vs. 15 (11-36 [5-115]) h (p = 0.01), respectively). An open-lung protective ventilation strategy during surgery for lung transplantation is feasible, safe and achieves favourable ventilation parameters.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intra‐operative protective mechanical ventilation in lung transplantation: a randomised, controlled trial

et al. 2017

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“…Longer ventilatory support with higher positive end-expiratory pressure and a low FiO 2 , strict fluid restriction and diuretic therapy can be helpful in minimising the alveolar transudation. [ 3 4 5 ]…”

Section: Discussionmentioning

confidence: 99%