A 360° Rotational Positioning Protocol of Organ Donors May Increase Lungs Available for Transplantation.

Autor:	Mendez MA; Department of Surgery, Truman Medical Center, University of Missouri Kansas City, Kansas City, MO., Fesmire AJ; Department of Surgery, Truman Medical Center, University of Missouri Kansas City, Kansas City, MO., Johnson SS; Via Christi St. Francis, Wichita, KS., Neel DR; Department of Surgery, Truman Medical Center, University of Missouri Kansas City, Kansas City, MO., Markham LE; Midwest Transplant Network, Mission, KS., Olson JC; University of Kansas Medical Center, Kansas City, MO., Ott M; Midwest Transplant Network, Mission, KS., Sangha H; Lake Regional Health System, Osage Beach, MO., Vasquez DG; Wesley Medical Center, Wichita, KS., Whitt SP; University of Missouri Health Care, Columbia, MO., Wilkins HE 3rd; Midwest Transplant Network, Mission, KS., Moncure M; Department of Surgery, Truman Medical Center, University of Missouri Kansas City, Kansas City, MO.
Jazyk:	angličtina
Zdroj:	Critical care medicine [Crit Care Med] 2019 Aug; Vol. 47 (8), pp. 1058-1064.
DOI:	10.1097/CCM.0000000000003805
Abstrakt:	Objectives: To evaluate the improvement in lung donation and immediate lung function after the implementation of a 360° rotational positioning protocol within an organ procurement organization in the Midwest. Design: Retrospective observational study. Setting: The Midwest Transplant Network from 2005 to 2017. Rotational positioning of donors began in 2008. Subjects: Potential deceased lung donors. Interventions: A 360° rotational protocol. Presence of immediate lung function in recipients, change in PaO2:FIO2 ratio during donor management, initial and final PaO2:FIO2 ratio, and proportion of lungs donated were measured. Outcomes were compared between rotated and nonrotated donors. Measurements and Main Results: A total of 693 donors were analyzed. The proportion of lung donations increased by 10%. The difference between initial PaO2:FIO2 ratio and final PaO2:FIO2 ratio was significantly different between rotated and nonrotated donors (36 ± 116 vs 104 ± 148; p < 0.001). Lungs transplanted from rotated donors had better immediate function than those from nonrotated donors (99.5% vs 68%; p < 0.001). Conclusions: There was a statistically significant increase in lung donations after implementing rotational positioning of deceased donors. Rotational positioning significantly increased the average difference in PaO2:FIO2 ratios. There was also superior lung function in the rotated group. The authors recommend that organ procurement organizations consider adopting a rotational positioning protocol for donors to increase the lungs available for transplantation.
Databáze:	MEDLINE
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