Severe mixed sleep apnea after bilateral lung transplantation in a cystic fibrosis patient: a case report.

Abstract

BACKGROUND:

Lung transplantation is the only treatment for end-stage lung disease in selected patients. After lung transplantation, patient recovery is often slow owing to severe underlying diseases in the patient producing hypoxemia before, during, and after surgery, as well as infections and rejection episodes. Postoperative breathing and ventillatory disorders are also associated with diaphragmatic dysfunction and/or phrenic nerve damage.

METHODS:

Herein we have reported a case of a 35-year-old man undergoing bilateral lung transplantation owing to worsening of chronic respiratory failure from cystic fibrosis. After uncomplicated surgery, weaning was delayed due to nighttime dyspnea and hypoxemia attributed to diaphragm dysfunction. After improvement of diaphragm function, the symptoms persisted, requiring noninvasive nocturnal ventilatory support. Polysomnography confirmed severe mixed sleep apnea.

RESULTS:

Effective treatment with noninvasive bi-level positive airway pressure spontaneous/timed mode (BiPAP S/T) ventilation during the nights rendered the patient symptom free. Polysomnography confirmed successful treatment.

CONCLUSION:

Disordered breathing while sleeping is common after solid organ transplantation. BiPAP S/T ventilator therapy was effective to the treat dominantly central sleep apnea in our patient.

• Authors: L Kunos, Z Kováts, G Muraközy, Z Süttö, A Bohács, K Czebe, G Lang, F Rényi-Vámos, W Klepetko, V Müller
• Journal: Transplantation proceedings (Transplant Proc) Vol. 43 Issue 4 Pg. 1292-3 (May 2011) ISSN: 1873-2623 [Electronic] United States
• PMID: 21620114 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Immunosuppressive Agents

Topics

• Adult
• Cystic Fibrosis (complications, surgery)
• Humans
• Immunosuppressive Agents (adverse effects)
• Lung Transplantation (adverse effects)
• Male
• Polysomnography
• Positive-Pressure Respiration
• Respiratory Insufficiency (etiology, surgery)
• Severity of Illness Index
• Sleep Apnea Syndromes (diagnosis, etiology, therapy)
• Time Factors
• Treatment Outcome