Ventilation in the prone position improves oxygenation and results in more lungs being transplanted from organ donors with hypoxemia and atelectasis.
Adult
Female
Follow-Up Studies
Humans
Hypoxia
/ diagnosis
Lung Transplantation
Male
Oxygen
/ metabolism
Oxygen Consumption
/ physiology
Preoperative Care
/ methods
Prone Position
Prospective Studies
Pulmonary Atelectasis
/ diagnosis
Respiration, Artificial
/ methods
Tissue Donors
Tissue and Organ Procurement
/ methods
Tomography, X-Ray Computed
atelectasis
hypoxemia
lung transplantation
organ donors
prone ventilation
Journal
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
ISSN: 1557-3117
Titre abrégé: J Heart Lung Transplant
Pays: United States
ID NLM: 9102703
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
20
07
2020
revised:
05
11
2020
accepted:
30
11
2020
pubmed:
20
12
2020
medline:
20
11
2021
entrez:
19
12
2020
Statut:
ppublish
Résumé
Hypoxemia is the most common barrier to lungs being transplanted from eligible organ donors who are brain dead (BD). Atelectasis is the principal reversible contributing factor to hypoxemia after brain death. We evaluated prospectively whether ventilation in the prone position in donors who are BD would reverse atelectasis, improve oxygenation, and result in more lungs being transplanted. Organ donors managed at the recovery center of 1 organ procurement organization over a 2-year period who exhibited hypoxemia (partial pressure of arterial oxygen [PaO A total of 40 lung-eligible donors who were BD with hypoxemia and atelectasis were managed in a prone position and compared with 79 donors in supine position. Baseline PaO Ventilation in the prone position reverses atelectasis and rapidly and sustainably improves oxygenation in organ donors who are BD with hypoxemia. This effect appears to translate into more lungs being transplanted.
Sections du résumé
BACKGROUND
Hypoxemia is the most common barrier to lungs being transplanted from eligible organ donors who are brain dead (BD). Atelectasis is the principal reversible contributing factor to hypoxemia after brain death. We evaluated prospectively whether ventilation in the prone position in donors who are BD would reverse atelectasis, improve oxygenation, and result in more lungs being transplanted.
METHODS
Organ donors managed at the recovery center of 1 organ procurement organization over a 2-year period who exhibited hypoxemia (partial pressure of arterial oxygen [PaO
RESULTS
A total of 40 lung-eligible donors who were BD with hypoxemia and atelectasis were managed in a prone position and compared with 79 donors in supine position. Baseline PaO
CONCLUSIONS
Ventilation in the prone position reverses atelectasis and rapidly and sustainably improves oxygenation in organ donors who are BD with hypoxemia. This effect appears to translate into more lungs being transplanted.
Identifiants
pubmed: 33339675
pii: S1053-2498(20)31859-3
doi: 10.1016/j.healun.2020.11.014
pii:
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
120-127Subventions
Organisme : NINDS NIH HHS
ID : K23 NS099440
Pays : United States
Informations de copyright
Copyright © 2020 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.