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Lung transplant, intensive care

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https://www.readbyqxmd.com/read/29019812/venous-thromboembolism-after-adult-lung-transplantation-a-frequent-event-associated-with-lower-survival
#1
Manuel L Ribeiro Neto, Marie Budev, Daniel A Culver, C Randall Lane, Marcelo Gomes, Xiao-Feng Wang, Paulo Novis Rocha, Mitchell A Olman
BACKGROUND: The incidence of venous thromboembolism (VTE) after lung transplantation (LTX) varies significantly across studies. Two studies have suggested that these thrombotic events are associated with a lower posttransplant survival. Herein, we sought to determine the incidence, predictors and impact of VTE on survival after LTX at a quaternary referral center. METHODS: This was a large cohort study of LTX recipients. Key outcome parameters were time to VTE after transplant and survival...
October 10, 2017: Transplantation
https://www.readbyqxmd.com/read/28976009/pain-fatigue-and-well-being-one-to-five-years-after-lung-transplantation-a-nationwide-cross-sectional-study
#2
Anna Forsberg, Matilda Claëson, Gull-Britt Dahlman, Annette Lennerling
RATIONALE AND AIM: Little is known about persistent pain after lung transplantation. Therefore, the aim was to present a multidimensional assessment of self-reported pain 1-5 years after lung transplantation and its relationship with fatigue and transplant-specific well-being. METHODS: This nationwide, cross-sectional cohort study is part of the self-management after thoracic transplantation study. A total of 117 lung recipients, all White, who were due for their annual follow-up at one (n = 35), two (n = 28), three (n = 23), four (n = 20) and 5 years (n = 11) after lung transplantation were included...
October 4, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28964417/continued-successful-evolution-of-extended-criteria-donor-lungs-for-transplantation
#3
Sakhee Kotecha, Jamie Hobson, Jeremy Fuller, Eldho Paul, Bronwyn J Levvey, Helen Whitford, Miranda Paraskeva, David McGiffin, Gregory I Snell, Glen P Westall
BACKGROUND: In an era of increasing ex vivo lung perfusion (EVLP) use, it remains important to describe what outcomes can be achieved without EVLP, by taking an aggressive approach to donor use to maximize lung transplantation. METHODS: Data for all lung transplant donor referrals to the Alfred Hospital in Melbourne, Australia were collected for 2012 to 2013. Donor variables were analyzed and calculated into a previously validated lung donor score. Lung transplant recipient outcome data included the following: primary graft dysfunction; duration of mechanical ventilation; need for cardiopulmonary bypass extracorporeal membrane oxygenation; intensive care and hospital length of stay; 30-day, 1-year, and 3- to 4-year survival rates; rates of acute rejection and chronic lung allograft dysfunction; and peak and 12-month lung function (forced expiratory volume in 1 second)...
September 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28925053/extracorporeal-membrane-oxygenation-can-save-lives-in-children-with-heart-or-lung-failure-after-liver-transplantation
#4
Sandrine Jean, Christophe Chardot, Mehdi Oualha, Carmen Capito, Olivier Bustarret, Philippe Pouard, Sylvain Renolleau, Florence Lacaille, Laurent Dupic
The risk of cardiac or lung failure after liver transplantation (LT) is significant. In rare cases, the usual intensive care techniques fail to maintain organ oxygenation with a risk of multiorgan dysfunction. Although extracorporeal membrane oxygenation (ECMO) is a difficult and risky procedure, it can be proposed as life-saving. Four children with either acute pulmonary (three) or cardiac (one) failure after LT, and the criteria that decided the use of ECMO (level of ventilation and results, dosage of inotropic drugs, cardiac ultrasound, blood lactate) were retrospectively reported...
September 2017: Artificial Organs
https://www.readbyqxmd.com/read/28917611/end-of-life-practice-patterns-at-u-s-adult-cystic-fibrosis-care-centers-a-national-retrospective-chart-review
#5
Elaine Chen, Karen Homa, Jessica Goggin, Kathryn A Sabadosa, Sarah Hempstead, Bruce C Marshall, Albert Faro, Elisabeth P Dellon
BACKGROUND: There are many challenges to providing end-of-life care (EOLC) to people with cystic fibrosis (CF). METHODS: Chart abstraction was used to examine EOLC in adults with CF who died between 2011 and 2013. RESULTS: We reviewed 248 deaths from 71 CF care centers. Median age at death was 29years (range 18-73). While median FEV1 was in the severe lung disease category (FEV1<40%), 38% had mild or moderate lung disease in the year preceding death...
September 13, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28905528/humidifier-disinfectant-associated-lung-injury-six-years-after-the-tragic-event
#6
REVIEW
Won Young Kim, Sang Bum Hong
In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients...
October 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28857906/lung-transplantation-after-125-days-on-ecmo-for-severe-refractory-hypoxemia-with-no-prior-lung-disease
#7
Shameen Salam, Robert Kotloff, Puneet Garcha, Sudhir Krishnan, Dhruv Joshi, Patrick Grady, Abhijit Duggal
Venovenous extracorporeal membrane oxygenation (ECMO) has become a viable and increasingly utilized option for the treatment of refractory hypoxemia in severe acute respiratory distress syndrome (ARDS). However, options are limited for ARDS patients who fail to wean from ECMO. The high rates of infection, presence of extrapulmonary end organ damage, intensive care unit-acquired weakness, and high short-term mortality associated with ARDS are all significant hurdles that make lung transplantation a difficult prospect to consider...
September 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28838437/urgent-lung-transplantation-in-severe-acute-respiratory-failure-based-on-rapidly-progressive-interstitial-lung-disease-a-case-report
#8
I Madurka, J Elek, N Schönauer, T Bartók, K Kormosói-Tóth, É Zöllei, Á Ghimessy, G Lang, W Klepetko, F Rényi-Vámos
Lung transplantation (LUTX) became a worldwide accepted standard therapy for certain well-defined chronic end-stage lung diseases. Until recently, patients on mechanical ventilation or extracorporeal life support techniques were hardly eligible for LUTX because of the inferior short-term results. However, a paradigm shift has occurred, and now these techniques represent bridging options to LUTX for listed patients. In the current practice, transplantation from the intensive care unit (ICU) is not extraordinary in patients on the waiting list...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28825952/the-impact-of-waiting-list-bmi-changes-on-the-short-term-outcomes-of-lung-transplantation
#9
Valérie Jomphe, Geneviève Mailhot, Véronic Damphousse, Muhammad-Ramzan Tahir, Olivier Receveur, Charles Poirier, Pasquale Ferraro
BACKGROUND: Obesity and underweight are associated with a higher postlung transplantation (LTx) mortality. This study aims to assess the impact of the changes in BMI during the waiting period for LTx on early postoperative outcomes. METHODS: Medical records of 502 consecutive cases of LTx performed at our institution between 1999 and 2015 were reviewed. Patients were stratified per change in BMI category between pre-LTx assessment (candidate BMI) and transplant BMI as follows: A-Candidate BMI<18...
August 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28803455/effect-of-positive-perioperative-donor-and-recipient-respiratory-bacterial-cultures-on-early-post-transplant-outcomes-in-lung-transplant-recipients
#10
Crystal K Howell, Christopher A Paciullo, Marshall G Lyon, David Neujahr, Peter Lyu, George Cotsonis, Michael Hurtik
BACKGROUND: It is standard practice to administer prophylactic antibiotics post lung transplantation. However, no studies have evaluated the impact of culture positivity. The purpose of this study was to evaluate early post-transplant outcomes of culture-positive and culture-negative lung transplant (LT) recipients and the appropriateness of the empiric regimens used. METHODS: Adult patients who received an LT at Emory University Hospital between January 1, 2010 and August 31, 2015 were reviewed and stratified into three groups: (i) culture-positive appropriate empiric treatment, (ii) culture-positive inappropriate empiric treatment, and (iii) culture-negative...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28797053/the-epidemiology-of-medically-attended-respiratory-syncytial-virus-in-older-adults-in-the-united-states-a-systematic-review
#11
REVIEW
Ann D Colosia, Jin Yang, Eric Hillson, Josephine Mauskopf, Catherine Copley-Merriman, Vivek Shinde, Jeffrey Stoddard
OBJECTIVE: This review was undertaken to assess the historical evidence of the disease incidence and burden of laboratory-confirmed respiratory syncytial virus (RSV) in medically attended older adults. DESIGN: A qualitative systematic literature review was performed; no statistical synthesis of the data was planned, in anticipation of expected heterogeneity across studies in this population. METHODS: A literature search of PubMed, Embase, and the Cochrane Library was conducted for studies of medically attended RSV in older adults (≥ 50 years) published in the last 15 years...
2017: PloS One
https://www.readbyqxmd.com/read/28790293/-critical-care-managements-after-lung-transplantation
#12
Masaki Anraku
Lung transplantation is a viable treatment option for patients with end-stage lung diseases such as interstitial pneumonia/pulmonary fibrosis, emphysema, pulmonary hypertension, and so on. Collecting available clinical, physiological, serological, and surgical information of both donor and recipient is vital when planning relevant postoperative managements. The goal of the managements is to keep the transplanted lung (s) functional while preventing/treating infection, rejection, and ischemiareperfusion lung injury...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28708843/prevalence-of-respiratory-viruses-among-adults-by-season-age-respiratory-tract-region-and-type-of-medical-unit-in-paris-france-from-2011-to-2016
#13
Benoit Visseaux, Charles Burdet, Guillaume Voiriot, François-Xavier Lescure, Taous Chougar, Olivier Brugière, Bruno Crestani, Enrique Casalino, Charlotte Charpentier, Diane Descamps, Jean-François Timsit, Yazdan Yazdanpanah, Nadhira Houhou-Fidouh
BACKGROUND: Multiplex PCR tests have improved our understanding of respiratory viruses' epidemiology by allowing their wide range detection. We describe here the burden of these viruses in hospital settings over a five-year period. METHODS: All respiratory samples from adult patients (>20 years old) tested by multiplex-PCR at the request of physicians, from May 1 2011 to April 30 2016, were included retrospectively. Viral findings are reported by season, patient age group, respiratory tract region (upper or lower) and type of clinical unit (intensive care unit, pneumology unit, lung transplantation unit and other medical units)...
2017: PloS One
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#14
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28691772/successful-liver-transplantation-despite-donor-transmitted-esbl-producing-klebsiella-pneumoniae-infection-case-report-and-review-of-the-literature
#15
Laura Escolà-Vergé, Ibai Los-Arcos, Juan José González-López, Mayli Lung, Itxarone Bilbao, Mercè Farré, Teresa Pont, Alberto Sandiumenge, Joan Gavaldà, Oscar Len
Donor-derived bacterial infection is a recognized complication of solid organ transplantation. Patients admitted to the intensive care unit are increasingly exposed to infection with multidrug-resistant microorganisms. However, no specific recommendations are available about their suitability as donors. We report a case of donor-transmitted extended-spectrum beta-lactamase-producing Klebsiella pneumoniae infection in a liver recipient, and review the related literature.
July 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28640022/brain-dead-donors-on-extracorporeal-membrane-oxygenation
#16
Régis Bronchard, Louise Durand, Camille Legeai, Johana Cohen, Patrice Guerrini, Olivier Bastien
OBJECTIVES: To describe donors after brain death with ongoing extracorporeal membrane oxygenation and to analyze the outcome of organs transplanted from these donors. DESIGN: Retrospective analysis of the national information system run by the French Biomedicine Agency (CRISTAL database). SETTING: National registry data of all donors after brain death in France and their organ recipients between 2007 and 2013. PATIENTS: Donors after brain death and their organ recipients...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28617166/challenges-in-providing-timely-physiotherapy-and-opportunities-to-influence-outcomes-for-potential-lung-donors
#17
Cassandra Raios, Jenny L Keating, Nicola Stitt, Helen I Opdam, Elizabeth H Skinner
CONTEXT: There is a critical shortage of donor lungs however, considerable ethical considerations are associated with the conduct of research to optimize care of the potential organ donor. OBJECTIVE: To investigate pathways of consent, respiratory care by physiotherapists and donation rates to contextualize future research on physiotherapy effects on donor lung suitability for procurement. DESIGN: Retrospective audit. SETTING: Australian tertiary hospital...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28597060/-early-bilateral-nephrectomy-in-neonatal-autosomal-recessive-polycystic-kidney-disease-improved-prognosis-or-unnecessary-effort
#18
REVIEW
S Riechardt, M Koch, J Oh, M Fisch
BACKGROUND: Neonatal autosomal recessive polycystic kidney disease (ARPKD) is associated with giant kidneys, lung hypoplasia, pulmonal hypertension, and end-stage renal failure. Depending on the study, mortality is reported to range between 20 and 80%. OBJECTIVES: Does bilateral nephrectomy improve survival? PATIENTS AND METHODS: Between 2010 and 2016, we treated 7 children with prenatally diagnosed ARPKD. All had a planned delivery by cesarean section...
July 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28596083/organ-donation-in-cardiac-arrest-patients-treated-with-extracorporeal-cpr-a-single-centre-observational-study
#19
Maria Chiara Casadio, Anna Coppo, Alessia Vargiolu, Jacopo Villa, Matteo Rota, Leonello Avalli, Giuseppe Citerio
AIM OF THE STUDY: In a consecutive cohort of cardiac arrest (CA) treated with extracorporeal cardiopulmonary resuscitation (eCPR), we describe the incidence of brain death (BD), the eligibility for organ donation and the short-term follow-up of the transplanted organs. METHODS: All refractory in- and out-of-hospital CA admitted to our Cardiac Intensive Care Unit between January 2011 and September 2016 treated with eCPR were enrolled in the study. RESULTS: 112 CA patients received eCPR...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28552627/perioperative-statin-use-is-associated-with-decreased-incidence-of-primary-graft-dysfunction-after-lung-transplantation
#20
Jacob Raphael, Stephen R Collins, Xin-Qun Wang, David C Scalzo, Priyanka Singla, Christine L Lau, Benjamin D Kozower, Marcel E Durieux, Randal S Blank
BACKGROUND: Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation. Statins reduce the risk of chronic rejection after lung transplantation, but their effects on PGD are unknown. We hypothesized that perioperative statin therapy decreases the risk for PGD after lung transplantation. METHODS: We retrospectively reviewed records of all patients undergoing lung transplantation between January 1999 and December 2014 at the University of Virginia Health System...
September 2017: Journal of Heart and Lung Transplantation
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