1. Efficacy of recruitment maneuver for improving the brain dead marginal lungs to ideal.
- Author
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Parto S, Shafaghi S, Khoddami-Vishteh HR, Makki SM, Abbasidezfuli A, Daneshvar A, Sheikhy K, Faeghi J, Ghorbani F, Parsa T, and Najafizadeh K
- Subjects
- Adolescent, Adult, Blood Gas Analysis, Bronchoscopy, Female, Humans, Iran, Lung physiopathology, Male, Prospective Studies, Pulmonary Atelectasis mortality, Pulmonary Atelectasis physiopathology, Pulmonary Edema mortality, Pulmonary Edema physiopathology, Treatment Outcome, Young Adult, Brain Death physiopathology, Lung surgery, Lung Transplantation adverse effects, Pulmonary Atelectasis therapy, Pulmonary Edema therapy, Respiration, Artificial methods, Tissue Donors supply & distribution
- Abstract
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 PaO2 200-300 mm Hg with FIO2 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 O2 saturation and patient's hemodynamic during. Finally, patients with normal bronchoscopy and PaO2/FIO2 >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 PaO2 with FIO2 100%., Results: The mean ± SD of PaO2/FIO2 with 100% FIO2 of patients before and after recruitment were 239 ± 62 and 269 ± 91, respectively. Recruitment maneuver could convert 10 marginal lungs (32%) to appropriate ones (PaO2 > 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., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
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