| Abstract | Bilevel positive airway pressure ventilation (BIPAP) has been used in cystic fibrosis (CF) patients as a bridge to transplantation. Our aim was to evaluate the effect of BIPAP use before transplantation on post-transplantation morbidity and mortality. We performed a retrospective study at a tertiary care center. Twelve CF patients (9 males; mean age = 26 years) were assessed. Group 1 consisted of eight patients that did not use BIPAP before lung transplantation. Group 2 comprised four patients who used BIPAP for 3-15 months while awaiting transplantation. Patients were evaluated before and two to ten years after transplantation. All eight patients who did not use BIPAP died two months to ten years after transplantation. All four BIPAP users are alive with no evidence of bronchiolitis obliterans two to eight years after lung transplantation. We demonstrated a significant improvement in acid-base balance (p < 0.01) and body mass index (p < 0.05) and a tendency toward improvement in the work of breathing and number of hospitalizations. We conclude that improvement in nutritional status and respiratory muscle strength before lung transplantation in BIPAP users may prevent post lung transplantation infection and acute rejection rate, which in turn may reduce chronic rejection (bronchiolitis obliterans) and improve long-term survival after lung transplantation. |
| Authors | Ori Efrati, Mordechai R Kremer, Asher Barak, Arie Augarten, Nira Reichart, Amir Vardi, Dalit Modan-Moses
(Affiliation: Pediatric Pulmonology Unit, Safra Children's Hospital, The Chaim Sheba Medical Center, 25621, Tel-Hashomer, Israel. ori.efrati at sheba.health.gov.il)
|
| Journal | Lung
(Lung)
2007 Mar-Apr
Vol. 185
Issue 2
Pg. 73-9
ISSN: 0341-2040 United States |
| PMID | 17393239
(Publication Type: Evaluation Studies, Journal Article)
|
| Topics |
- Acid-Base Equilibrium
(physiology)
- Adolescent
- Adult
- Body Mass Index
- Bronchiolitis Obliterans
(etiology, prevention & control)
- Child
- Cystic Fibrosis
(mortality, physiopathology, therapy)
- Female
- Graft Rejection
(physiopathology, prevention & control)
- Humans
- Intermittent Positive-Pressure Ventilation
- Lung
(physiopathology, surgery)
- Lung Transplantation
(adverse effects, mortality, physiology)
- Male
- Nutritional Status
- Retrospective Studies
- Survival Rate
- Time Factors
|
