How to minimise ventilator-induced lung injury in transplanted lungs: The role of protective ventilation and other strategies

Eur J Anaesthesiol. 2015 Dec;32(12):828-36. doi: 10.1097/EJA.0000000000000291.

Abstract

Lung transplantation is the treatment of choice for end-stage pulmonary diseases. In order to avoid or reduce pulmonary and systemic complications, mechanical ventilator settings have an important role in each stage of lung transplantation. In this respect, the use of mechanical ventilation with a tidal volume of 6 to 8 ml kg(-1) predicted body weight, positive end-expiratory pressure of 6 to 8 cmH2O and a plateau pressure lower than 30 cmH2O has been suggested for the donor during surgery, and for the recipient both during and after surgery. For the present review, we systematically searched the PubMed database for articles published from 2000 to 2014 using the following keywords: lung transplantation, protective mechanical ventilation, lung donor, extracorporeal membrane oxygenation, recruitment manoeuvres, extracorporeal CO2 removal and noninvasive ventilation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Extracorporeal Membrane Oxygenation / methods
  • Humans
  • Lung Transplantation / adverse effects*
  • Positive-Pressure Respiration / methods
  • Postoperative Care / methods*
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Respiration, Artificial / adverse effects*
  • Tidal Volume / physiology
  • Ventilator-Induced Lung Injury / etiology
  • Ventilator-Induced Lung Injury / prevention & control*