MECHANICAL VENTILATION FOR THE LUNG TRANSPLANT RECIPIENT

Lindsey Barnes; Robert M Reed; Kalpaj R Parekh; Jay K Bhama; Tahuanty Pena; Srinivasan Rajagopal; Gregory A Schmidt; Julia A Klesney-Tait; Michael Eberlein

doi:10.1007/s13665-015-0114-8

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MECHANICAL VENTILATION FOR THE LUNG TRANSPLANT RECIPIENT

Journal article

Peer reviewed

MECHANICAL VENTILATION FOR THE LUNG TRANSPLANT RECIPIENT

Lindsey Barnes, Robert M Reed, Kalpaj R Parekh, Jay K Bhama, Tahuanty Pena, Srinivasan Rajagopal, Gregory A Schmidt, Julia A Klesney-Tait and Michael Eberlein

Current pulmonology reports, Vol.4(2), pp.88-96

06/2015

DOI: 10.1007/s13665-015-0114-8

PMCID: PMC4610154

PMID: 26495241

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Abstract

Mechanical ventilation (MV) is an important aspect in the intraoperative and early postoperative management of lung transplant (LTx)-recipients. There are no randomized-controlled trials of LTx-recipient MV strategies; however there are LTx center experiences and international survey studies reported. The main early complication of LTx is primary graft dysfunction (PGD), which is similar to the adult respiratory distress syndrome (ARDS). We aim to summarize information pertinent to LTx-MV, as well as PGD, ARDS, and intraoperative MV and to synthesize these available data into recommendations. Based on the available evidence, we recommend lung-protective MV with low-tidal-volumes (≤6 mL/kg predicted body weight [PBW]) and positive end-expiratory pressure for the LTx-recipient. In our opinion, the MV strategy should be based on donor characteristics (donor PBW as a parameter of actual allograft size), rather than based on recipient characteristics; however this donor-characteristics-based protective MV is based on indirect evidence and requires validation in prospective clinical studies.

mechanical ventilation

Lung transplantation

acute respiratory distress syndrome

lung protective ventilation

ventilator induced lung injury

tidal volume

primary graft dysfunction

Details

Title: Subtitle: MECHANICAL VENTILATION FOR THE LUNG TRANSPLANT RECIPIENT
Creators: Lindsey Barnes - Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
Robert M Reed - Division of Pulmonary and Critical Care Medicine, University of Maryland
Kalpaj R Parekh - Department of Thoracic and Cardiovascular Surgery, University of Iowa Hospitals and Clinics
Jay K Bhama - Department of Thoracic and Cardiovascular Surgery, University of Iowa Hospitals and Clinics
Tahuanty Pena - Division of Allergy, Pulmonary and Critical Care Medicine, University of Pennsylvania
Srinivasan Rajagopal - Department of Anesthesia, University of Iowa Hospitals and Clinics
Gregory A Schmidt - Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
Julia A Klesney-Tait - Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
Michael Eberlein - Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics
Resource Type: Journal article
Publication Details: Current pulmonology reports, Vol.4(2), pp.88-96
DOI: 10.1007/s13665-015-0114-8
PMID: 26495241
PMCID: PMC4610154
NLM abbreviation: Curr Pulmonol Rep
ISSN: 2199-2428
eISSN: 2199-2428
Language: English
Date published: 06/2015
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Anatomy and Cell Biology; Stead Family Department of Pediatrics; Surgery; Anesthesia; Cardiothoracic Surgery; Internal Medicine
Record Identifier: 9984007165702771

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