Improving Lung Procurement and Utilization Rates Using Clinical Practice Guidelines for Ventilation Management

Purpose The utilization of donor's lungs in the US has averaged 21% over the last decade. Alveolar recruitment maneuvers can improve lungs transplanted per donor (LTPD). Donor management goals (DMGs) are endpoints transplant clinicians strive to demonstrate organ recovery from the brain-death process. In a US organ procurement organization (OPO), three recruitment maneuvers (continuous positive airway pressure, step-up PEEP, and inverse ratio ventilation) were trialed against each other. Three years later, the practice of these techniques waned, and a program was created to improve the utilization of the recruitment maneuvers in their clinical practice guidelines (CPGs). Methods An educational activity was performed based on information gathered from a needs assessment questionnaire of the OPO clinicians’ experiences with recruitment maneuvers. Afterwards an evaluation completed by the attendees reported perceptions of the intervention. Then, a comparison between organs transplanted per donor (OTPD), DMGs and LTPD were made two months after the intervention and compared to a continuous sample of donors that were managed two months prior. Results A content analysis of the needs assessment (n=25) demonstrated a need to review the organization's CPGs. After the educational module there was an improvement in, (1) organs transplanted per donor (3.0 vs. 4.21; p = Conclusion The intent of this scholarship was to show an educational intervention may help remove barriers that limited performing recruitment maneuvers and improve donor management in the perioperative period. Future studies are indicated.