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Lung transplant, intensive care

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https://www.readbyqxmd.com/read/29892177/acute-on-chronic-liver-failure-in-hospital-predictors-of-mortality-in-icu
#1
Sujay Kulkarni, Mithun Sharma, Padaki N Rao, Rajesh Gupta, Duvvuru N Reddy
Aims: We studied in-hospital predictors of mortality of acute on chronic liver failure (ACLF) in Indian patients. Methods: Patients admitted to the intensive care unit of our institute fulfilling the definition of ACLF based on the Asia-Pacific Association for Study of Liver Disease (APASL) consensus were included. Complete history and medical evaluation to assess the etiology of underlying liver cirrhosis and to identify the acute precipitating insult of worsening liver function was done...
June 2018: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29879861/blood-products-transfusion-and-mid-term-outcomes-of-lung-transplanted-patients-under-extracorporeal-membrane-oxygenation-support
#2
Tommaso Pettenuzzo, Giulio Faggi, Guido Di Gregorio, Marco Schiavon, Giuseppe Marulli, Dario Gregori, Federico Rea, Carlo Ori, Paolo Feltracco
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is considered a reliable technique in lung transplantation requiring cardiorespiratory support. However, the impact of this technology on blood product transfusion rate and outcomes compared to off-pump lung transplantation has been rarely investigated. METHODS: Between January 2012 and June 2015, 52 elective adult lung transplants were performed at our institution. Of these, 15 recipients required intraoperative venoarterial extracorporeal support and 37 did not...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29868836/the-liver-first-approach-for-combined-lung-and-liver-transplantation
#3
Jawad Salman, Gerrit Grannas, Fabio Ius, Wiebke Sommer, Thiery Siemeni, Murat Avsar, Christian Kuehn, Dietmar Boethig, Felix Fleissner, Dmitry Bobylev, Jens Gottlieb, Juergen Klempnauer, Tobias Welte, Axel Haverich, Igor Tudorache, Gregor Warnecke, Frank Lehner
OBJECTIVES: Combined lung and liver transplantation (Lu-LTx) is an established therapy for patients with cystic fibrosis. The initial sequence has primarily been lung first. We changed the sequence to 'liver first' in 2006. The aim of this study is to present outcomes of this procedure. METHODS: The records of combined lung and liver transplant patients treated at our institution between April 1999 and November 2016 were reviewed retrospectively. RESULTS: A total of 27 patients received a combined Lu-LTx at our institute...
June 3, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29851823/inhaled-nitric-oxide-therapy-was-not-associated-with-postoperative-acute-kidney-injury-in-patients-undergoing-lung-transplantation-a-retrospective-pilot-study
#4
Hyun-Su Ri, Hyo Jung Son, Han Byeol Oh, Su-Young Kim, Ju Yeon Park, Ju Yeon Kim, Yoon Ji Choi
Inhaled nitric oxide (iNO) therapy is commonly used in lung transplantation (LT) recipients during the perioperative periods. However, previous studies report that the use of iNO may increase the risk of renal dysfunction. Post-LT acute kidney injury (AKI) can lead to critical situations, including prolonged intensive care unit or hospital stays and increased morbidity and mortality. Accordingly, the aim of this study was to investigate the relationship between iNO therapy and incidence of post-LT AKI in LT recipients...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29800126/the-feasibility-of-extubation-in-the-operating-room-after-bilateral-lung-transplantation-in-adult-emphysema-patients-an-observational-retrospective-study
#5
Valentina Assenzo, Cristina Assenzo, Rosalinda Filippo, Morgan Le Guen, Edouard Sage, Antoine Roux, Marc Fischler, Ngai Liu
OBJECTIVES: We introduced an extubation strategy for emphysema patients after bilateral lung transplantation. Patients who met the extubation criteria were extubated in the operating room (OR) followed by non-invasive ventilation, and the other patients were extubated in the intensive care unit (ICU). The primary objective was to determine the extubation rate. The secondary outcomes were to determine the factors allowing for extubation in the OR and the postoperative course. METHODS: This study is a single-centre retrospective database analysis of 96 patients...
May 23, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29799380/a-quality-improvement-program-to-reduce-the-time-on-the-lung-transplant-waiting-list-at-the-nantes-university-hospital
#6
Isabelle Danner-Boucher, Véronique Loppinet, Aurore Boxus, Claire Dary, Anne Brigitte Lambert, Marine Prieur, Céline Vallet, Adrien Tissot
BACKGROUND: In 2010, the time on the lung transplant waiting list in Nantes University Hospital (NUH) was 9.2 months, compared to a French national median of about 4 months. The NUH transplant unit performs both heart and lung transplantations, which can be seen as competing activities. To fix the problem, the adult Cystic Fibrosis (CF) team decided to engage in the French CF Quality Improvement Program (QIP PHARE-M) in 2012. The objectives were: i) To reduce the time on the lung transplant waiting list at the Nantes Transplant Unit by increasing the number of lung transplants per year twhile maintaining a 5-year survival rate above the French national average...
February 8, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29796751/effect-of-early-tracheostomy-on-clinical-outcomes-in-critically-ill-lung-transplant-recipients
#7
Ryo Miyoshi, Toyofumi F Chen-Yoshikawa, Masatsugu Hamaji, Atsushi Kawaguchi, Hidenao Kayawake, Kyoko Hijiya, Hideki Motoyama, Akihiro Aoyama, Hiroshi Date
OBJECTIVES: The purpose of this study was to evaluate the effect of early tracheostomy in patients following lung transplantation and to determine its optimal timing and influence on clinical outcomes. METHODS: We retrospectively reviewed records of 96 adult patients who underwent lung transplantation at our institution between August 2008 and January 2016. Time-to-tracheostomy was defined based on timing of the procedure: "early" if less than 3 days or "late" if 3 or more days after lung transplantation...
May 23, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29766320/weaning-from-prolonged-veno-venous-extracorporeal-membrane-oxygenation-ecmo-after-transfer-to-a-specialized-center-a-retrospective-study
#8
Frederik Seiler, Franziska C Trudzinski, Sabrina I Hörsch, Annegret Kamp, Carlos Metz, Monika Flaig, Mohammad Alqudrah, Holger Wehrfritz, Markus Kredel, Ralf M Muellenbach, Hendrik Haake, Robert Bals, Philipp M Lepper
Veno-venous extracorporeal membrane oxygenation (vvECMO) is increasingly used as rescue therapy in severe respiratory failure. In patients with pre-existent lung diseases or persistent lung injury weaning from vvECMO can be challenging. This study sought to investigate outcomes of patients transferred to a specialized ECMO center after prolonged ECMO therapy. We performed a retrospective analysis of all patients admitted to our medical intensive care unit (ICU) between 01/2013 and 12/2016 who were transferred from an external ICU after > 8 days on vvECMO...
May 15, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29754733/assessing-the-benefits-of-preoperative-thoracic-epidural-placement-for-lung-transplantation
#9
Sean R McLean, Peter von Homeyer, Aaron Cheng, Michael L Hall, Michael S Mulligan, Kevin Cain, Kei Togashi
OBJECTIVE: The authors investigated the effect of preoperative thoracic epidural (PreTE) catheter placement versus not placing a preoperative thoracic epidural catheter (NoPreTE) on the duration of postoperative ventilation time, time to become coherent (measured as time to become Confusion Assessment Method-intensive care unit [ICU] negative), opioid consumption, ICU length of stay (LOS), and hospital LOS. DESIGN: Retrospective cohort design. SETTING: Single institution, university hospital...
April 3, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29732185/ambulatory-veno-venous-extracorporeal-membrane-oxygenation
#10
REVIEW
Jonas Andersson Lindholm
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is used for support in patients with severe respiratory failure. The method allows extracorporeal gas exchange and may replace the patient's lung function for weeks and even years. ECMO is not a contraindication for lung transplant. The most important factor for a good outcome is the physiological status of the patient when accepted for transplantation. Ambulatory ECMO makes it possible for the patient to exercise and walk, and provides the best outcome for high risk patients in severe respiratory failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29731080/carbapenem-resistant-acinetobacter-baumannii-bacteremia-in-liver-transplant-recipients
#11
Y J Kim, S I Kim, Y D Lee, H J Choi, J Y Choi, S K Yoon, Y-K You, D-G Kim
BACKGROUND: Acinetobacter baumannii has become an increasingly important nosocomial pathogen. Carbapenem is the preferred drug of choice for treatment of multidrug-resistant gram-negative bacilli, but carbapenem-resistant A baumannii (CRAB) has now emerged. The aim of this study was to determine the incidence, outcomes, and risk factors for CRAB bacteremia in liver transplant recipients. METHODS: The medical records of 393 subjects who underwent living donor liver transplant at Seoul St...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29689120/acute-on-chronic-liver-failure-getting-ready-for-prime-time
#12
Jasmohan S Bajaj, Richard Moreau, Patrick S Kamath, Hugo E Vargas, Vicente Arroyo, K Rajender Reddy, Gyongyi Szabo, Puneeta Tandon, Jody Olson, Constantine Karvellas, Thierry Gustot, Jennifer C Lai, Florence Wong
Acute on chronic liver failure (ACLF) is a culmination of chronic liver disease and extra-hepatic organ failures, which is associated with a high short-term mortality and immense healthcare expenditure. There are varying definitions for organ failures and ACLF in Europe, North America and Asia. These differing definitions need to be reconciled to enhance progress in the field. The pathogenesis of ACLF is multi-factorial and related to interactions between the immuno-inflammatory system, microbiota and the precipitating factors...
April 24, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29620796/recent-alcohol-use-prolongs-hospital-length-of-stay-following-lung-transplant
#13
Erin M Lowery, Meagan Yong, Arala Cohen, Cara Joyce, Elizabeth J Kovacs
Little is known about the alcohol habits of people with advanced lung disease. Following lung transplantation patients are asked to abstain from or minimize alcohol use. The aim of this investigation is to assess alcohol use in a cohort of patients with advanced lung disease undergoing evaluation for lung transplant. This is a prospective observational investigation comparing patient self-report of alcohol use with their responses on the Alcohol Use Disorder and Identification Test, and alcohol biomarkers collected at the time of transplant...
April 5, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29599422/fatal-acute-respiratory-distress-syndrome-due-to-influenza-a-h1n1-infection-in-patients-after-kidney-transplantation-a-report-of-five-cases
#14
Paweł Zatorski, Agata Adamczyk, Maciej Kosieradzki, Teresa Baczkowska, Dariusz Kosson, Janusz Trzebicki
BACKGROUND In the general population, swine influenza is a self-limited infection. Patients after kidney transplantation, however, are at increased risk for complications and mortality from influenza A (H1N1). Acute respiratory distress syndrome (ARDS) complicates up to 55% of influenza-related pneumonia in hospitalized patients and carries a mortality of 40-46%. We describe our experience in intensive care of kidney transplant patients with ARDS complicating influenza A (H1N1) pneumonia during a flu outbreak...
March 30, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29587521/orthotopic-heart-transplantation-in-children
#15
Nagarajan Muthialu
Heart transplantation is a relatively infrequent but technically demanding procedure in pediatric cardiac surgery. Orthotopic heart transplantation is often offered to older children or adolescents following multiple previous operations, but with advances in intensive care, diagnostics, and management, more infants with complex congenital heart diseases are being listed for transplantation. Primary cardiomyopathies remain the most common indication. Outcomes following cardiothoracic transplantation have improved steadily in recent times...
May 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29579767/donation-after-brain-death-versus-donation-after-circulatory-death-lung-donor-management-issues
#16
Gregory I Snell, Bronwyn J Levvey, Kovi Levin, Miranda Paraskeva, Glen Westall
Lung transplantation (LTx) has traditionally been limited by a lack of suitable donor lungs. With the recognition that lungs are more robust than initially thought, the size of the donor pool of available lungs has increased dramatically in the past decade. Donation after brain death (DBD) and donation after circulatory death (DCD) lungs, both ideal and extended are now routinely utilized. DBD lungs can be damaged. There are important differences in the public's understanding, legal and consent processes, intensive care unit strategies, lung pathophysiology, logistics, and potential-to-actual donor conversion rates between DBD and DCD...
April 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29559375/contemporary-outcomes-of-ecmo-used-as-bridge-to-lung-transplantation
#17
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29552956/intensive-care-of-pulmonary-complications-following-liver-transplantation
#18
Justin K Lui, Lidia Spaho, Erik Holzwanger, Rosa Bui, Jennifer S Daly, Adel Bozorgzadeh, Scott E Kopec
Chronic liver disease has been associated with pulmonary dysfunction both before and after liver transplantation. Post-liver transplantation pulmonary complications can affect both morbidity and mortality often necessitating intensive care during the immediate postoperative period. The major pulmonary complications include pneumonia, pleural effusions, pulmonary edema, and atelectasis. Poor clinical outcomes have been known to be associated with age, severity of liver dysfunction, and preexisting lung disease as well as perioperative events related to fluid balance, particularly transfusion and fluid volumes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29550627/microbiologic-diagnostic-workup-of-acute-respiratory-failure-with-pulmonary-infiltrates-after-allogeneic-hematopoietic-stem-cell-transplantation-findings-in-the-era-of-molecular-and-biomarker-based-assays
#19
Philipp Wohlfarth, Amin T Turki, Joerg Steinmann, Melanie Fiedler, Nina K Steckel, Dietrich W Beelen, Tobias Liebregts
Allogeneic hematopoietic stem cell transplantation (HSCT) recipients frequently develop acute respiratory failure (ARF) with pulmonary infiltrates. Molecular- and biomarker-based assays enhance pathogen detection, but data on their yield in this population are scarce. This was a retrospective single-center study of 156 consecutive HSCT recipients admitted to the intensive care unit (ICU) between May 2013 and July 2017. Findings from a microbiologic diagnostic workup using currently available methods on bronchoalveolar lavage (BAL) and blood samples from 66 patients (age, 58 years [range, 45 to 64]; HSCT to ICU, 176 days [range, 85 to 407]) with ARF and pulmonary infiltrates were analyzed...
March 14, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29531748/randomised-clinical-trial-of-an-early-palliative-care-intervention-support-for-patients-with-idiopathic-pulmonary-fibrosis-ipf-and-their-caregivers-protocol-and-key-design-considerations
#20
Kathleen Oare Lindell, Mehdi Nouraie, Melinda J Klesen, Sara Klein, Kevin F Gibson, Daniel J Kass, Margaret Quinn Rosenzweig
Introduction: Idiopathic pulmonary fibrosis (IPF), a progressive life-limiting lung disease affects approximately 128 000 newly diagnosed individuals in the USA annually. IPF, a disease of ageing associated with intense medical and financial burden, is expected to grow in incidence globally. Median survival from diagnosis is 3.8 years, and many of these patients succumb to a rapid death within 6 months. Despite the fatal prognosis, we have found that patients and caregivers often fail to understand the poor prognosis as the disease relentlessly progresses...
2018: BMJ Open Respiratory Research
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