Simple changes to how ventilators are used could almost double the number of lungs available for transplants, according to new international research involving a doctor at St. Michael's Hospital.
Many potential donor lungs deteriorate between the time a patient is declared brain dead and the time the lungs are evaluated to determine whether they are suitable for transplant. The study involving Dr. Arthur Slutsky, the hospital's vice president of research, said the deterioration could be in part because of the ventilatory strategy used while potential donors were observed just prior to being declared brain dead.
His team, lead by Dr. Marco Ranieri of the University of Turin in Italy, tested a "lung protective strategy" on patients in 12 hospitals in Spain and Italy that resulted in a significant increase in the number of viable donor lungs that were transplanted. Their results are published in the current issue of the Journal of the American Medical Association.
The strategy involved using smaller "tidal volumes," meaning less air was pumped into the lungs with each breath, to prevent injury to the lungs. It also used higher "positive-end expiratory pressure," the amount of pressure applied by the ventilator at the end of an exhalation, to prevent lungs from collapsing.
"A lot of patients who are waiting for lung transplants die before they get a transplant because there aren't enough organs," said Dr. Slutsky, the only Canadian on the research team. "By using this lung protective strategy, one can essentially double the number of lungs available for transplant."
The randomized study involved 118 patients. Of the 59 patients treated with conventional ventilation, 32 (54 per cent) met lung donor eligibility criteria. Of those on the lung protective strategy, 56 (95 per cent) met the criteria. Ultimately, double the number of lungs was transplanted in the group treated with the lung protective strategy.
According to the Canadian Institute for Health Information, 1,222 lung transplants were performed in Canada between 1997 and 2006, but 299 people died while waiting for a transplant. There were 252 people waiting to receive lung transplants in 2006, up from 119 in 1997.
"This is pretty simple and easy to implement," Dr. Slutsky said. "It's not like a fancy new drug or equipment. You just have to change the ventilator a little bit."
Dr. Slutsky said some doctors and hospitals may already be following a similar "lung protective strategy" but this is the first published randomized clinical trial showing it works, which could lead to standards that all hospitals would follow.
"If this is adopted widely, we think it will increase the number of lungs available for transplant, increase the quality of life for some people and probably save the lives of some people who are on the waiting list," he said.
About St. Michael's Hospital:
St. Michael's Hospital provides compassionate care to all who enter its doors. The Hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital's recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing Knowledge Institute, research at St. Michael's Hospital is recognized and put into practice around the world. Founded in 1892, the Hospital is fully affiliated with the University of Toronto.
Leslie Shepherd | EurekAlert!
Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan
Prospect for more effective treatment of nerve pain
20.02.2017 | Universität Zürich
Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...
The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.
The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...
Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...
Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".
Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...
13.02.2017 | Event News
10.02.2017 | Event News
09.02.2017 | Event News
21.02.2017 | Earth Sciences
21.02.2017 | Medical Engineering
21.02.2017 | Trade Fair News