Division of Pulmonary and Critical Care Medicine, New York Methodist Hospital, Brooklyn, NY.
Respiratory Care Services, Massachusetts General Hospital, Boston, MA.
Chest. 2014 Jul;146(1):220-227. doi: 10.1378/chest.12-2745.
Lung transplantation reduces mortality in patients with end-stage lung disease; however, only approximately 21% of lungs from potential donor patients undergo transplantation. A large number of donor lungs become categorized as unsuitable for lung transplantation as a result of lung injury around the time of brain death. Limiting this injury is key to increasing the number of successful lung procurements and subsequent transplants. This narrative review by a working group of pulmonologists, respiratory therapists, and lung transplant specialists elucidates principles of mechanical ventilatory support that can be used to limit lung injury in potential lung donor patients and examines the implementation of protocolized strategies in enhancing the procurement of donor lungs for transplantation.
肺移植可降低终末期肺病患者的死亡率;然而,只有大约 21%的潜在供体患者的肺进行了移植。由于脑死亡时肺部损伤,大量供体肺被归类为不适合肺移植。限制这种损伤是增加成功肺采集和随后移植数量的关键。由一组肺科医生、呼吸治疗师和肺移植专家组成的工作组对这篇叙述性评论进行了阐述,说明了机械通气支持的原则,这些原则可用于限制潜在肺供体患者的肺损伤,并探讨了实施协议化策略以增强供体肺移植的获取。