Efficacy of Recruitment Maneuver for Improving the Brain Dead Marginal Lungs to Ideal
| Autor: | Shadi Shafaghi, Kambiz Sheikhy, A. Daneshvar, Tahereh Parsa, J. Faeghi, Katayoun Najafizadeh, S. Mohammad Makki, S. Parto, Fariba Ghorbani, A. Abbasi-Dezfuli, H.R. Khoddami-Vishteh |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Brain Death Pulmonary Atelectasis medicine.medical_specialty Adolescent medicine.medical_treatment Hemodynamics Pulmonary Edema Iran Young Adult Bronchoscopy Recruitment maneuver medicine Humans Lung transplantation Prospective Studies Lung Brain dead Transplantation medicine.diagnostic_test business.industry respiratory system Respiration Artificial Tissue Donors respiratory tract diseases Surgery Treatment Outcome medicine.anatomical_structure Anesthesia Arterial blood Female Blood Gas Analysis business Lung Transplantation |
| Zdroj: | Transplantation Proceedings. 45:3531-3533 |
| ISSN: | 0041-1345 |
| Popis: | Background Because of the shortage of lungs for transplantation, finding the suitable lungs in brain-dead donors is an important issue. Recruitment maneuver is a strategy aimed at re-expanding collapsed and edematous lung tissue. The aim of this study was to assess the efficacy of this maneuver on improving marginal lungs for transplantation. Methods From 127 brain-dead potential donor which were evaluated for lung donation in Masih Daneshvari Organ Procurement Unit of Tehran, Iran, 31 (25%) had marginal lungs for transplantation. These donors had normal chest X ray or bilateral infiltration and had PaO 2 200–300 mm Hg with FIO 2 100%. The recruitment maneuver was performed and arterial blood gas was obtained before and after maneuver. The maneuver lasts for 2 hours with continuous check of O 2 saturation and patient's hemodynamic during. Finally, patients with normal bronchoscopy and PaO 2 /FIO 2 >300 mm Hg were considered good candidates for lung transplantation. The frequency (%) and mean ± SD were used for description of variables and the Wilcoxon test was used for comparison between pre- and post-maneuver PaO 2 with FIO 2 100%. Results The mean ± SD of PaO 2 /FIO 2 with 100% FIO 2 of patients before and after recruitment were 239 ± 62 and 269 ± 91, respectively. Recruitment maneuver could convert 10 marginal lungs (32%) to appropriate ones (PaO 2 > 300) and finally 8 lungs were transplanted. Conclusions Findings of this study showed that recruitment maneuver could convert inappropriate lungs to appropriate ones in one third of brain-dead patients who had marginal lung condition. So, it is recommended that this maneuver is considered in the assessment protocol of lungs for donation. |
| Databáze: | OpenAIRE |
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