Particle Flow Profiles From the Airways Measured by PExA Differ in Lung Transplant Recipients Who Develop Primary Graft Dysfunction
Broberg, Ellen LU ; Hyllén, Snejana LU ; Algotsson, Lars LU ; Wagner, Darcy E LU
and Lindstedt, Sandra
LU
(2019)
In Experimental and clinical transplantation
17(6).
p.803-812
- 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... (More)
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: In our study group, 6 patients did not develop primary graft dysfunction and 6 developed primary graft dysfunction. Patients with primary graft dysfunction underwent mechanical ventilation significantly longer; they also showed a stepwise increase in particle count from day 0 until extubation. We observed no adverse events related to the PExA 2.0 device.
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.
(Less)
- author
- Broberg, Ellen
LU
; Hyllén, Snejana
LU
; Algotsson, Lars
LU
; Wagner, Darcy E
LU
and Lindstedt, Sandra
LU
- organization
-
- Pediatric anesthesia and intensive care (research group)
- Clinical and experimental lung transplantation (research group)
- Anesthesiology and Intensive Care
- Thoracic Surgery
- Cardiothoracic anesthesia and intensive care (research group)
- Less invasive cardiac surgery (research group)
- WCMM-Wallenberg Centre for Molecular Medicine
- Lung Bioengineering and Regeneration (research group)
- NPWT technology (research group)
- DCD transplantation of lungs (research group)
- StemTherapy: National Initiative on Stem Cells for Regenerative Therapy
- publishing date
- 2019-12-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Artificial respiration, Intensive care, Lung transplantation
- in
- Experimental and clinical transplantation
- volume
- 17
- issue
- 6
- pages
- 10 pages
- publisher
- Baskent University
- external identifiers
-
- scopus:85076876767
- pmid:31615381
- ISSN
- 1304-0855
- DOI
- 10.6002/ect.2019.0187
- language
- English
- LU publication?
- yes
- id
- 8fd6c0ca-ce85-45ad-8a60-3952df65eee9
- date added to LUP
- 2019-10-21 11:45:59
- date last changed
- 2024-04-16 21:52:51
@article{8fd6c0ca-ce85-45ad-8a60-3952df65eee9,
abstract = {{<p>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.</p><p>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.</p><p>RESULTS: In our study group, 6 patients did not develop primary graft dysfunction and 6 developed primary graft dysfunction. Patients with primary graft dysfunction underwent mechanical ventilation significantly longer; they also showed a stepwise increase in particle count from day 0 until extubation. We observed no adverse events related to the PExA 2.0 device.</p><p>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.</p>}},
author = {{Broberg, Ellen and Hyllén, Snejana and Algotsson, Lars and Wagner, Darcy E and Lindstedt, Sandra}},
issn = {{1304-0855}},
keywords = {{Artificial respiration; Intensive care; Lung transplantation}},
language = {{eng}},
month = {{12}},
number = {{6}},
pages = {{803--812}},
publisher = {{Baskent University}},
series = {{Experimental and clinical transplantation}},
title = {{Particle Flow Profiles From the Airways Measured by PExA Differ in Lung Transplant Recipients Who Develop Primary Graft Dysfunction}},
url = {{http://dx.doi.org/10.6002/ect.2019.0187}},
doi = {{10.6002/ect.2019.0187}},
volume = {{17}},
year = {{2019}},
}