Please use this identifier to cite or link to this item: http://192.168.1.35:80/jspui/handle/Hannan/31990
Title: Mechanical ventilation after lung transplantation
Authors: Thakuria, L;Davey, R;Romano, R;Carby, MR;Kaul, S;Griffiths, MJ;Simon, AR;Reed, AK;Marczin, N
subject: Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
General & Internal Medicine
Mechanical ventilation
Lung transplantation
PRIMARY GRAFT DYSFUNCTION
ISHLT WORKING GROUP
RESPIRATORY-DISTRESS-SYNDROME
END-EXPIRATORY PRESSURE
PROTECTIVE VENTILATION
ORGAN DONORS
RISK-FACTORS
INJURY
STRATEGIES
MANAGEMENT
Lung transplantation
Mechanical ventilation
Adult
Analysis of Variance
Female
Humans
Intensive Care Units
Length of Stay
Lung Transplantation
Male
Middle Aged
Positive-Pressure Respiration
Respiration, Artificial
Retrospective Studies
Tidal Volume
Humans
Tidal Volume
Respiration, Artificial
Length of Stay
Positive-Pressure Respiration
Lung Transplantation
Analysis of Variance
Retrospective Studies
Adult
Middle Aged
Intensive Care Units
Female
Male
Emergency & Critical Care Medicine
Clinical Sciences
1110 Nursing
Year: 19-Jul-2017
Publisher: WB Saunders
place: National Institute for Health Research
Description: Introduction: To explore the hypothesis that early ventilation strategies influence clinical outcomes in lung transplantation, we have examined our routine ventilation practices in terms of tidal volumes (Vt) and inflation pressures. Methods: A total of 124 bilateral lung transplants between 2010 and 2013 were retrospectively assigned to low (b6 mL/kg), medium (6-8 mL/kg), and high (N8 mL/kg) Vt groups based on ventilation characteristics during the first 6 hours after surgery. Those same 124 patients were also stratified to low-pressure (b25 cm H2O) and high-pressure (≥25 cm H2O) groups. Results: Eighty percent of patients were ventilated using pressure control mode. Low, medium, and high Vt were applied to 10%, 43%, and 47% of patients, respectively. After correcting for patients requiring extracorporeal support, there was no difference in short-term to midterm outcomes among the different Vt groups. Low inflation pressures were applied to 61% of patients, who had a shorter length of intensive care unit stay (5 vs 12 days; P = .012), higher forced expiratory volume in 1 second at 3 months (77.8% vs 60.3%; P b .001), and increased 6-month survival rate (95% vs 77%; P = .008). Conclusion: Low Vt ventilation has not been fully adopted in our practice. Ventilation with higher inflation pressures, but not Vt, was significantly associated with poorer outcomes after lung transplantation.
URI: http://localhost/handle/Hannan/31990
https://spiral.imperial.ac.uk:8443/handle/10044/1/48532
Standard no: 0883-9441
https://dx.doi.org/10.1016/j.jcrc.2015.09.021
BRU 6279
Type Of Material: Article
Appears in Collections:Department of Surgery and Cancer

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