Optimizing Nutrition Assessment to Create Better Outcomes in Lung Transplant Recipients: A Review of Current Practices

Gulling, Mara Weber; Schaefer, Monica; Bishop-Simo, Laura; Keller, Brian C.

doi:10.20944/preprints201911.0013.v1

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…Most lung transplant recipients have ESLD, and their complex conditions may lead to malnutrition (17). Malnutrition can increase the risk of respiratory infections, affect the immune system, and even worsen the function of respiratory muscles (18), which can affect the incidence of postoperative complications and mortality (19). However, in the scoring standards recognized for recipient selection among patients with ESLD worldwide, there is a lack of focus on nutritional status (20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

Ding¹,

Chen²,

Chen³

et al. 2022

Ann Transl Med

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Background: Lung transplantation is an effective treatment for saving the lives of patients with end-stage lung disease (ESLD). Lung transplant-related morbidity and mortality has significantly higher than other solid organ transplants. Among the pre-transplant variables that affect the survival rate after transplantation, nutritional status are associated with poor survival rate. In order to provide basis for formulating nutritional evaluations for lung transplant recipients in the future, we retrospectively analyzed the nutritional status of lung transplantation recipients and explore its correlation with the short-term prognosis.Methods: This retrospective cohort study included patients who were hospitalized in 2020 and underwent lung transplant surgery at Shanghai Pulmonary Hospital. Inclusion criteria: (I) aged ≥18 years; (II) have been diagnosed with ESLD; (III) have received no other effective treatments; (IV) have undergone a transplantation at Shanghai Pulmonary Hospital. We summarized the patients' general information, including their sex, age, major lung disease etc. And we also collected nutritional status, such as Nutritional Risk Screening 2002 (NRS 2002), subjective global assessment (SGA) and nutritionalrelated indicators, including albumin, prealbumin, retinol-binding protein etc. before surgery and 1 month after surgery. In addition, we collected postoperative drainage volume, length of stay in intensive care unit (ICU), total hospital days, and hospitalization costs to evaluate the short-term prognosis.Results: A total of 33 lung transplant recipients were included and successfully underwent surgery. Of the patients, 16 had preoperative NRS 2002 scores ≥3 points, of whom 7 were assessed by the SGA as having mild-moderate malnutrition and 9 as having severe malnutrition. The albumin indexes of these 16 patients, including their prealbumin, and calcium contents, were significantly lower than those of patients with NRS scores <3. Patients with preoperative NRS scores ≥3 had higher drainage volumes, longer hospitalization times, and higher total hospitalization costs than those with NRS scores <3.Conclusions: Lung transplant recipients have a higher incidence of nutritional risk and malnutrition, which seriously affects their short-term prognosis. Thus, in clinical practice, lung transplant recipients should be screened for nutritional risk and provided preoperative nutritional support to maintain a good preoperative status to improve their prognosis.

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Section: Discussionmentioning

confidence: 99%

Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

Ding¹,

Chen²,

Chen³

et al. 2022

Ann Transl Med

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“…Gastrostomy tube placement is an effective means for providing long-term nutritional support in patients with functioning guts who cannot tolerate oral intake [ 4 , 5 ]. In particular, patients with end stage lung disease and pulmonary cachexia require optimization of nutritional status to prevent morbidity and mortality associated with the stress and caloric needs of lung transplantation [ [6] , [7] , [8] ]. Compared to surgical and endoscopic placement, percutaneous radiologic gastrostomy tube placement can be done with local anesthetic only, which limits the risk of aspiration and cardiopulmonary compromise in patients with reduced pulmonary function [5] .…”

Section: Introductionmentioning

confidence: 99%

A method for percutaneous radiologic gastrostomy tube placement without sedation as a bridge to lung transplantation

Nguyen

Imani

2021

Radiology Case Reports

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Gastrostomy tube placement is an appropriate option for long-term nutritional support for patients who cannot tolerate oral intake. Common indications for a gastrostomy tube include head and neck tumors and neurological disorders. Several methods for gastrostomy tube insertion exist (eg, surgical, endoscopic, and radiologic) that require sedation or general anesthesia, which can pose risks of cardiopulmonary compromise and postsurgical pulmonary complications. Unlike other methods, our practice uses a percutaneous balloon-assisted gastrostomy tube insertion method for which we can perform without sedation. We report a case of a percutaneous radiologic gastrostomy procedure for a patient with end stage lung disease as a bridge to lung transplantation, who is not a candidate for sedation and is high-risk for general anesthesia. Through enteral feeds administered through the successfully placed gastrostomy tube, the patient showed steady improvement in weight gain over the course of several months before approval for listing by the lung transplant selection committee. Our case highlights how gastrostomy tube placement can be safely performed in patients who are not sedation candidates using the minimally invasive balloon-assisted gastrostomy tube insertion method and local anesthetic.

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Optimizing Nutrition Assessment to Create Better Outcomes in Lung Transplant Recipients: A Review of Current Practices

Cited by 2 publications

References 21 publications

Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

Evaluation of nutritional status in lung transplant recipients and its correlation with post-transplant short-term prognosis: a retrospective study

A method for percutaneous radiologic gastrostomy tube placement without sedation as a bridge to lung transplantation

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