Abstract | OBJECTIVES:
Primary graft dysfunction is a severe form of acute lung injury and a major cause of early morbidity and mortality encountered after lung transplant.We used a customized PExA 2.0 instrument (PExA, Gothenburg, Sweden) to measure particle flow in exhaled air during mechanical ventilation in the intensive care unit. Our objective was to discover whether patients who developed primary graft dysfunction had different particle flow patterns from the airways. We used volume-controlled ventilation and pressure-controlled ventilation to see whether changes in particle patterns could be observed in both mechanical ventilation settings. MATERIALS AND METHODS: First, we investigated whether it was safe to use a customized PExA 2.0 in conjunction with mechanical ventilation. Next, 12 lung transplant patients were randomized to either daily volumecontrolled ventilation or pressure-controlled ventilation as the first mode of treatment until extubation. RESULTS: CONCLUSIONS: This study suggests that the PExA 2.0 device is safe to use in conjunction with mechanical ventilation in the intensive care unit. Lung transplant patients who developed primary graft dysfunction showed a different particle profile from the airways before clinical signs of primary graft dysfunction developed. Online assessment of ventilation impact before presentation of tissue changes may allow realtime detection of primary graft dysfunction, thus preventing or reducing its effects.
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Authors | Ellen Broberg, Snejana Hyllén, Lars Algotsson, Darcy E Wagner, Sandra Lindstedt |
Journal | Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
(Exp Clin Transplant)
Vol. 17
Issue 6
Pg. 803-812
(12 2019)
ISSN: 2146-8427 [Electronic] Turkey |
PMID | 31615381
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Topics |
- Airway Extubation
- Breath Tests
(instrumentation)
- Equipment Design
- Female
- Humans
- Lung Transplantation
(adverse effects)
- Male
- Middle Aged
- Predictive Value of Tests
- Primary Graft Dysfunction
(diagnosis, etiology, physiopathology)
- Respiration, Artificial
(adverse effects)
- Risk Factors
- Sweden
- Time Factors
- Treatment Outcome
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