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Protective Strategy Raises Number of Harvested Lungs

Different ventilator approach increases number of lungs eligible for transplant

TUESDAY, Dec. 14 (HealthDay News) -- Use of a more protective ventilator strategy may increase the number of eligible and harvested lungs from potential organ donors with brain death, according to research published in the Dec. 15 issue of the Journal of the American Medical Association.

Luciana Mascia, M.D., Ph.D., of the University of Turin in Italy, and colleagues randomized 118 potential organ donors with beating hearts to either the conventional ventilatory strategy or a lung protective strategy. The former consisted of tidal volumes of 10 to 12 mL/kg of predicted body weight, positive end-expiratory pressure (PEEP) of 3 to 5 cm H2O, apnea tests performed by disconnecting the ventilator, and open circuit for airway suction; the latter consisted of tidal volumes of 6 to 8 mL/kg of predicted body weight, PEEP of 8 to 10 cm H2O, apnea tests performed by using continuous positive airway pressure, and closed circuit for airway suction.

The researchers found that, of the 59 potential donors in the conventional strategy group, 32 met lung donor eligibility criteria after the six-hour observation period, whereas 56 of the 59 in the protective strategy group met the criteria. Lungs were harvested from 16 of the conventional group and 32 of the protective group. Six-month survival rates did not differ between those who received lungs from one group or the other.

"In conclusion, our results suggest that the use of a lung protective strategy prevents the decline of pulmonary function consequent to brain death and roughly [doubles] the number of lungs available for transplantation," the authors write.

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