Prone Positioning as a Bridge to Recovery From Refractory Hypoxemia After Oversized Lung Transplant.
Journal
Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532
Informations de publication
Date de publication:
Historique:
received:
06
08
2019
revised:
27
02
2020
accepted:
12
03
2020
pubmed:
16
5
2020
medline:
20
4
2021
entrez:
16
5
2020
Statut:
ppublish
Résumé
Size matching is an important challenge in lung transplantation. Although the survival rate after lung transplantation with an oversized allograft was improved, it is associated with substantial immediate postoperative morbidity and mortality. Prone positioning is a rescue therapy showing improved outcomes in acute respiratory distress syndrome. We present a case of immediate postoperative refractory hypoxemia after oversized lung transplantation treated by prone positioning. A 62-year-old man was transferred to our hospital by our extracorporeal membrane oxygenation (ECMO) transport team because of acute exacerbation of idiopathic pulmonary fibrosis. He underwent bilateral lung transplantation through bilateral anterior thoracotomy. For size matching between donor and recipient, multiple wedge resection and lingular segmentectomy were performed, but an oversized lung was implanted. On the immediate postoperative day, chest radiography revealed haziness in the left lower quadrant and the patient had an increased O This case demonstrated the safety and feasibility of prone positioning during the immediate postoperative period after lung transplant by bilateral anterior thoracotomy. Prone positioning successfully reversed postoperative atelectasis and improved primary graft dysfunction after oversized lung transplant.
Sections du résumé
BACKGROUND
BACKGROUND
Size matching is an important challenge in lung transplantation. Although the survival rate after lung transplantation with an oversized allograft was improved, it is associated with substantial immediate postoperative morbidity and mortality. Prone positioning is a rescue therapy showing improved outcomes in acute respiratory distress syndrome. We present a case of immediate postoperative refractory hypoxemia after oversized lung transplantation treated by prone positioning.
METHODS
METHODS
A 62-year-old man was transferred to our hospital by our extracorporeal membrane oxygenation (ECMO) transport team because of acute exacerbation of idiopathic pulmonary fibrosis. He underwent bilateral lung transplantation through bilateral anterior thoracotomy. For size matching between donor and recipient, multiple wedge resection and lingular segmentectomy were performed, but an oversized lung was implanted. On the immediate postoperative day, chest radiography revealed haziness in the left lower quadrant and the patient had an increased O
CONCLUSIONS
CONCLUSIONS
This case demonstrated the safety and feasibility of prone positioning during the immediate postoperative period after lung transplant by bilateral anterior thoracotomy. Prone positioning successfully reversed postoperative atelectasis and improved primary graft dysfunction after oversized lung transplant.
Identifiants
pubmed: 32409225
pii: S0041-1345(19)31091-7
doi: 10.1016/j.transproceed.2020.03.022
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
273-275Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.