The role of mechanical ventilation in primary graft dysfunction in the postoperative lung transplant recipient: A single center study and literature review

Niroomand, Anna; Qvarnström, Sara; Stenlo, Martin; Malmsjö, Malin; Ingemansson, Richard; Hyllén, Snejana; Lindstedt, Sandra

doi:10.1111/aas.14025

Cited by 9 publications

(18 citation statements)

References 58 publications

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“…There were 3/11 studies that reported the association between tidal volume and PGD grade within the first 72 h 9,10,15 . Two of the studies identified no significant association 9,15 .…”

Section: Resultsmentioning

confidence: 99%

“…The positive‐end expiratory pressure (PEEP) was reported in 8/11 studies with a range from 5 to 12 cmH 2 O 9–15,18 . The method of PEEP selection was reported in 1/11 studies, which included initial PEEP selection based on a protocol 9 .…”

Section: Resultsmentioning

confidence: 99%

“…The primary outcomes included PGD grade (4/11 studies), 9,10,15,16 P : F ratio (2/11), 13,14 ventilation parameters (4/11) 11,17–19 and ventilation duration (1/11) 12 . A secondary outcome of note from Tague et al was a reduced risk of death at 1 year associated with dLPV (hazard ratio: 0.49; 95% CI: 0.27–0.88; p = .018) 10 …”

Section: Resultsmentioning

confidence: 99%

“…16,18 Patients with undersized grafts were ventilated with higher tidal volumes in mL/kg dPBW when compared with oversized grafts (11.4 ± 3.1 vs. 8.1 ± 2.1, p < .05) (see Tables 1 and 2). 18 There were 3/11 studies that reported the association between tidal volume and PGD grade within the first 72 h. 9,10,15 Two of the studies identified no significant association. 9,15 The single study 10 that identified an association between tidal volume in mL/kg dPBW and the patient-centred outcomes of PGD grade and 1-year mortality, reported only the initial and maximal tidal volume.…”

Section: Tidal Volumementioning

confidence: 99%

“…p = .035), increased ICU length of stay(12 [4-36] vs. 5 days[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], p = .012) and reduced 6-month survival (77% vs. 95%, p = .008) 15. Only 4/11 studies9,11,15,18 reported the dynamic driving pressure, and no studies reported the static driving pressure. Dezube et al18 reported dynamic driving pressures in three size-match sub-groups over the first 96 h (22.4, 23.6 and 23.6 cmH 2 O) that likely breech the proposed safety limit (15 cmH 2 O) for static driving pressure identified by Amato et al…”

mentioning

confidence: 99%

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Mechanical ventilation post‐bilateral lung transplantation: A scoping review

Morgan

Åneman

Nair

2023

Acta Anaesthesiol Scand

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Background: Evidence from lung protective ventilation (LPV) in the acute respiratory distress syndrome has commonly been applied to guide periprocedural ventilation in lung transplantation. However, this approach may not adequately consider the distinctive features of respiratory failure and allograft physiology in the lung transplant recipient.This scoping review was conducted to systematically map the research describing ventilation and relevant physiological parameters post-bilateral lung transplantation with the aim to identify any associations with patient outcomes and gaps in the current knowledge base.Methods: To identify relevant publications, comprehensive literature searches of electronic bibliographic databases were conducted with the guidance of an experienced librarian in MEDLINE, EMBASE, SCOPUS and the Cochrane Library. The search strategies were peer-reviewed using the PRESS (Peer Review of Electronic Search Strategies) checklist. The reference lists of all relevant review articles were surveyed.Publications were included in the review if they described relevant ventilation parameters in the immediate post-operative period, published between 2000 and 2022 and involved human subjects undergoing bilateral lung transplantation. Publications were excluded if they included animal models, only single-lung transplant recipients or only patients managed with extracorporeal membrane oxygenation.Results: A total of 1212 articles were screened, 27 were subject to full-text review and 11 were included in the analysis. The quality of the included studies was assessed to be poor with no prospective multi-centre randomised controlled trials.The frequency of reported retrospective LPV parameters was as follows: tidal volume (82%), tidal volume indexed to both donor and recipient body weight (27%) and plateau pressure (18%). Data suggest that undersized grafts are at risk of unrecognised higher tidal volume ventilation indexed to donor body weight. The most reported patient-centred outcome was graft dysfunction severity in the first 72 h.

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“…There were 3/11 studies that reported the association between tidal volume and PGD grade within the first 72 h 9,10,15 . Two of the studies identified no significant association 9,15 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%