Pulmonary rehabilitation protocols in urgent lung transplantation patients.

IF 2.6 3区医学 Q1 EMERGENCY MEDICINE

World journal of emergency medicine Pub Date : 2024-01-01 DOI:10.5847/wjem.j.1920-8642.2024.015

Fei Zeng, Lingyun Cai, Luyao Guo, Meijuan Lan, Jiangshuyuan Liang, Peipei Gu

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引用次数: 0

Abstract

Background: Prolonged invasive respiratory support and extracorporeal membrane oxygenation (ECMO) in patients requiring urgent lung transplantation (ULTx) present significant challenges to clinical practice due to severe underlying diseases and complex conditions. The aim of the study was to report the clinical outcomes of patients who received ULTx and followed the perioperative rehabilitation protocol implemented in a lung transplant center.

Methods: A retrospective analysis was conducted in ULTx patients who required preoperative invasive mechanical ventilation (IMV) and ECMO between January 2018 and January 2023. Data were retrieved from electronic medical records at our lung transplant center.

Results: Fourteen patients (mean age 57.43±10.97 years; 12 males, 2 females) underwent ULTx with bridging ECMO and IMV. The mean body mass index was 23.94±3.33 kg/m², and the mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 21.50±3.96. The Nutritional Risk Screening 2002 (NRS 2002) scores were ≥3. ULTx was performed after an 8.5-day waiting period (interquartile interval [IQR] 5.0-26.5 d). Following the surgeries, the average lengths of ECMO and IMV were 1.0 (IQR 1.0-2.0) d and 5.0 (IQR 3.0-7.3) d, respectively. The total length of hospital stay was 60.1±30.8 d, with an average intensive care unit stay of 38.3±22.9 d and post-operative hospitalization stay of 45.8±26.1 d. Two patients died within 30 d after ULTx, with a 30-day survival rate of 85.71%.

Conclusion: Patients receiving ULTx showed an acceptable short-term survival rate, validating the practicality and safety of the treatment protocols implemented in our center.

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紧急肺移植患者的肺康复方案。

背景：由于严重的基础疾病和复杂的病情，需要紧急肺移植（ULTx）的患者需要长时间的侵入性呼吸支持和体外膜氧合（ECMO），这给临床实践带来了巨大挑战。本研究旨在报告肺移植中心实施围手术期康复方案并接受 ULTx 患者的临床结果：研究对 2018 年 1 月至 2023 年 1 月期间需要术前有创机械通气（IMV）和 ECMO 的 ULTx 患者进行了回顾性分析。数据来自我们肺移植中心的电子病历：14名患者（平均年龄（57.43±10.97）岁；12名男性，2名女性）接受了桥接ECMO和IMV的超量移植手术。平均体重指数为（23.94±3.33）kg/m²，平均急性生理学和慢性健康评估（APACHE）II 评分为（21.50±3.96）分。营养风险筛查 2002（NRS 2002）评分≥3。超乳手术是在 8.5 天的等待期（四分位间间隔 [IQR] 5.0-26.5 天）后进行的。手术后，ECMO 和 IMV 的平均时间分别为 1.0 天（IQR 1.0-2.0 天）和 5.0 天（IQR 3.0-7.3 天）。住院总时间为（60.1±30.8）天，其中重症监护室平均住院时间为（38.3±22.9）天，术后住院时间为（45.8±26.1）天：结论：接受超短焦距放射治疗的患者短期生存率尚可，验证了本中心所实施的治疗方案的实用性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World journal of emergency medicine EMERGENCY MEDICINE-

CiteScore

2.50

自引率

28.60%

发文量

671

期刊介绍： The journal will cover technical, clinical and bioengineering studies related to multidisciplinary specialties of emergency medicine, such as cardiopulmonary resuscitation, acute injury, out-of-hospital emergency medical service, intensive care, injury and disease prevention, disaster management, healthy policy and ethics, toxicology, and sudden illness, including cardiology, internal medicine, anesthesiology, orthopedics, and trauma care, and more. The journal also features basic science, special reports, case reports, board review questions, and more. Editorials and communications to the editor explore controversial issues and encourage further discussion by physicians dealing with emergency medicine.