Lung transplantation for emphysema. Lung hyperinflation: incidence and outcome

Anglès, Roser; Tenorio, Luis Enrique David; Román, Antonio; Soler, Joan Curbet; Rochera, M. I.; Latorre, Francisco-José de

doi:10.1007/s00147-004-0714-7

Cited by 7 publications

(10 citation statements)

References 19 publications

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“…However, little is known about how airway diameter changes, such as those in airway obstruction, affect unilateral lung hyperinflation. Anglès et al [15] reported that after unilateral lung transplantation, the incidence of hyperinflation in the remaining native lung reached 64% during hospitalization. Lung hyperinflation led to longer ICU stays and higher mortality rates (67% vs. 20%) compared with patients without lung hyperinflation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Respiratory Dynamics in an Asymmetric Lung Compliance Model

Yun¹,

Lee²,

Lee³

et al. 2017

Korean J Crit Care Med

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Background Unilateral lung hyperinflation develops in lungs with asymmetric compliance, which can lead to vital instability. The aim of this study was to investigate the respiratory dynamics and the effect of airway diameter on the distribution of tidal volume during mechanical ventilation in a lung model with asymmetric compliance.Methods Three groups of lung models were designed to simulate lungs with a symmetric and asymmetric compliance. The lung model was composed of two test lungs, lung1 and lung2. The static compliance of lung1 in C15, C60, and C120 groups was manipulated to be 15, 60, and 120 ml/cmH2O, respectively. Meanwhile, the static compliance of lung2 was fixed at 60 ml/cmH2O. Respiratory variables were measured above (proximal measurement) and below (distal measurement) the model trachea. The lung model was mechanically ventilated, and the airway internal diameter (ID) was changed from 3 to 8 mm in 1-mm increments.Results The mean ± standard deviation ratio of volumes distributed to each lung (VL1/VL2) in airway ID 3, 4, 5, 6, 7, and 8 were in order, 0.10 ± 0.05, 0.11 ± 0.03, 0.12 ± 0.02, 0.12 ± 0.02, 0.12 ± 0.02, and 0.12 ± 0.02 in the C15 group; 1.05 ± 0.16, 1.01 ± 0.09, 1.00 ± 0.07, 0.97 ± 0.09, 0.96 ± 0.06, and 0.97 ± 0.08 in the C60 group; and 1.46 ± 0.18, 3.06 ± 0.41, 3.72 ± 0.37, 3.78 ± 0.47, 3.77 ± 0.45, and 3.78 ± 0.60 in the C120 group. The positive end-expiratory pressure (PEEP) of lung1 was significantly increased at airway ID 3 mm (1.65 cmH2O) in the C15 group; at ID 3, 4, and 5 mm (2.21, 1.06, and 0.95 cmH2O) in the C60 group; and ID 3, 4, and 5 mm (2.92, 1.84, and 1.41 cmH2O) in the C120 group, compared to ID 8 mm (P < 0.05).Conclusions In the C15 and C120 groups, the tidal volume was unevenly distributed to both lungs in a positive relationship with lung compliance. In the C120 group, the uneven distribution of tidal volume was improved when the airway ID was equal to or less than 4 mm, but a significant increase of PEEP was observed.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Respiratory Dynamics in an Asymmetric Lung Compliance Model

Yun¹,

Lee²,

Lee³

et al. 2017

Korean J Crit Care Med

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“…The literature indicates that single-lung transplantation has a higher mortality rate than double-lung transplantation. The risk of death in emphysema patients receiving a single-lung transplant was nine-fold higher than in the patients who underwent the bilateral procedure 15. In addition, the improved long-term survival of double-lung over single-lung recipients among patients with emphysema remains a favorable prognostic factor in the International Society of Heart and Lung Transplantation (ISHLT) registry 16…”

Section: Discussionmentioning

confidence: 99%

“…However, even in non-suppurative diseases, there seems to be prolonged improvement when bilateral transplants are performed. For example, in patients with COPD who underwent bilateral lung transplantation, superior lung function and a trend towards improved long-term survival were observed despite apparent equity between the two methods when exercise tolerance and quality of life were assessed 3,15…”

Section: Introductionmentioning

confidence: 99%

Spirometric Assessment of Lung Transplant Patients: One Year Follow-Up

Pêgo-Fernandes

Abrão

Fernandes

et al. 2009

Clinics

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OBJECTIVE: The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation. INTRODUCTION: Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections. METHODS: We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed. RESULTS: The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) in comparison to the pre-transplant values (p <0.05). Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation. DISCUSSION: The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery. CONCLUSION: Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function

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“…The reported frequency of use of ILV in SLT series for obstructive airways disease also varies widely, from 0% [13][14][15][16][17] to 43%, 18 with an overall frequency of ILV use of 9%. 6,[13][14][15][16][17][18][19][20][21] This compares with 12% in our study.…”

Section: Discussionmentioning

confidence: 99%