The treatment strategy of early ALI after liver transplantation.
- Author:
Hui-min YI
1
;
Chang-jie CAI
;
Min-qiang LU
;
Gen-shu WANG
;
Shu-hong YI
;
Yang YANG
;
Chi XU
;
Hua LI
;
Gui-hua CHEN
Author Information
- Publication Type:Journal Article
- MeSH: Combined Modality Therapy; Female; Humans; Liver Transplantation; adverse effects; Male; Middle Aged; Oxygen Inhalation Therapy; Postoperative Complications; therapy; Prospective Studies; Respiration, Artificial; methods; Respiratory Distress Syndrome, Adult; etiology; therapy
- From: Chinese Journal of Surgery 2006;44(13):889-893
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the treatment strategy of early acute lung injury (ALI) after liver transplantation.
METHODS18 patients complicated with ALI after liver transplantation were given comprehensive therapies and two minutes of recruitment maneuver (RM) to open previously collapsed lung units and then lung protective ventilatory strategy within 3 hours of hypoxemia. The inspiratory pressure was 25 cm H2O and PEEP 17 cm H2O. Optimal PEEP were maintained after RM to stabilize lung volume.
RESULTSThe PaO(2), SaO(2) and PaO(2)/FiO(2) of all 18 patients were improved greatly. RM was effective in 17 patients except one case of severe pulmonary infection, whose PaO(2)/FiO(2) was only improved by 40%. PaO(2), SaO(2) and PaO(2)/FiO(2) were increased by 68 mm Hg, 9.5%, and 104.7% respectively. And the improved oxygenation can be maintained 2 - 24 hours. The effective rate of RM was 94.4%. All 18 patients were weaned and extubated successfully with the survival rate of 100%. RM was well tolerated without complications.
CONCLUSIONALI post liver transplantation should be diagnosed and treated in early stage. RM combined with lung protective ventilatory strategy is a safe and effective treatment for early ALI after liver transplantation.
