Effect of a Lung Protective Strategy for Organ Donors on Eligibility and Availability of Lungs for Transplantation
| Autor: | Silvia Boifava, Marina Munari, Luciana Mascia, Pier Paolo Donadio, Claudia Filippini, Ilaria Mastromauro, Francesco Della Corte, Salvatore Grasso, Arthur S. Slutsky, Paolo Malacarne, E. L. Martin, Maurizio Berardino, Daniela Pasero, Paolo Del Gaudio, Nicoletta Vivaldi, Giuseppe Cornara, S. Livigni, Elisabeth Zavala, M. Jose Arguis, V. Marco Ranieri |
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| Přispěvatelé: | Mascia L, Pasero D, Slutsky AS, Arguis MJ, Berardino M, Grasso S, Munari M, Boifava S, Cornara G, Della Corte F, Vivaldi N, Malacarne P, Del Gaudio P, Livigni S, Zavala E, Filippini C, Martin EL, Donadio PP, Mastromauro I, Ranieri VM. |
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Context (language use) law.invention Randomized controlled trial law Intensive care medicine Lung transplantation Organ donation Continuous positive airway pressure Positive end-expiratory pressure Lung Donor selection business.industry Apnea General Medicine respiratory system Confidence interval respiratory tract diseases Surgery Transplantation medicine.anatomical_structure n/a Adult Eligibility Determination Female Humans Male Middle Aged Single-Blind Method Suction Survival Analysis Donor Selection Lung Transplantation Positive-Pressure Respiration Tissue Donors Medicine (all) Anesthesia medicine.symptom business |
| Zdroj: | JAMA. 304:2620 |
| ISSN: | 0098-7484 |
| DOI: | 10.1001/jama.2010.1796 |
| Popis: | Many potential donor lungs deteriorate between the time of brain death and evaluation for transplantation suitability, possibly because of the ventilatory strategy used after brain death. To test whether a lung protective strategy increases the number of lungs available for transplantation. Multicenter randomized controlled trial of patients with beating hearts who were potential organ donors conducted at 12 European intensive care units from September 2004 to May 2009 in the Protective Ventilatory Strategy in Potential Lung Donors Study. Interventions Potential donors were randomized to the conventional ventilatory strategy (with tidal volumes of 10-12 mL/kg of predicted body weight, positive end-expiratory pressure [PEEP] of 3-5 cm H(2)O, apnea tests performed by disconnecting the ventilator, and open circuit for airway suction) or the protective ventilatory strategy (with tidal volumes of 6-8 mL/kg of predicted body weight, PEEP of 8-10 cm H(2)O, apnea tests performed by using continuous positive airway pressure, and closed circuit for airway suction). The number of organ donors meeting eligibility criteria for harvesting, number of lungs harvested, and 6-month survival of lung transplant recipients. RESULTS: The trial was stopped after enrolling 118 patients (59 in the conventional ventilatory strategy and 59 in the protective ventilatory strategy) because of termination of funding. The number of patients who met lung donor eligibility criteria after the 6-hour observation period was 32 (54%) in the conventional strategy vs 56 (95%) in the protective strategy (difference of 41% [95% confidence interval CI, 26.5% to 54.8%]; P |
| Databáze: | OpenAIRE |
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