Prolonged independent lung respiratory treatment after single lung transplantation in pulmonary emphysema

V. Gavazzeni, G. Iapichino, D. Mascheroni, M. Langer, G. Bordone, P. Zannini, D. Radrizzani, G. Damia

Research output: Contribution to journalArticlepeer-review

Abstract

Single lung transplantation (SLT) is now successfully used in patients with severe emphysema. Mechanical imbalance between the native emphysematous and the healthy transplanted lung can be easily managed, unless severe graft failure occurs, leading to acute respiratory failure. Emergency retransplantation has been used in this setting, since the conventional approach to adult respiratory distress syndrome (ARDS) (mechanical ventilation and positive end-expiratory pressure [PEEP]) fails, due to the mechanical discrepancy between the two lungs. We describe two cases of severe graft failure following SLT in emphysema patients that were successfully treated with prolonged independent respiratory treatment. Mechanical ventilation and PEEP were applied to the failing transplanted lung while the native emphysematous lung was maintained on spontaneous breathing to avoid hyperexpansion and barotrauma. The independent lung respiratory treatment lasted 35 and 25 days, respectively: to our knowledge, these are among the longest-lasting independent respiratory treatments reported. The management was simplified by the early use of a double-lumen tracheostomy cannula as an alternative to orotracheal double lumen tube.

Original languageEnglish
Pages (from-to)96-100
Number of pages5
JournalChest
Volume103
Issue number1
Publication statusPublished - 1993

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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