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Lung transplantation may be option for some ventilator-dependent patients

Last Updated: 2001-02-28 10:00:48 EST (Reuters Health)

WESTPORT, CT (Reuters Health) - Long-term mechanical ventilation is not an absolute contraindication to lung transplantation, results of a small retrospective study suggest.

Dr. Maher A. Baz, from the University of Florida, in Gainesville, and colleagues compared the outcomes of nine patients who were on long-term ventilator support before lung transplantation with 65 "control" patients who did not require mechanical ventilation prior to transplantation. The researchers selected patients who were ventilator dependent for at least 13 days, and in one case more than 5 years, but who were medically stable, undergoing physical therapy and without active infection.

The 1-year survival rates and lung function were comparable in the two groups, with 78% of patients in the mechanical ventilation group and 83% of patients in the control group alive at 1 year. The ventilator-dependent patients had a significantly longer stay on the ventilator posttransplantation than the control group, 41 days vs 9 days, but there was no significant difference in their outcome at 1 year after transplantation, Dr. Baz told Reuters Health.

"In general, patients on mechanical ventilation are considered at two to three times higher risk for early death after lung transplantation," he said. "Also, most and probably all of them have no realistic chance of being extubated. However, we have always thought that there is probably a select subgroup of those patients that can have an outcome comparable to the rest. Our retrospective analysis confirmed our hypothesis."

Based on the findings, Dr. Baz and colleagues think it may be time to "reevaluate our thinking about some select ventilator-dependent patients as far as their outcome after lung transplantation."

The findings appear in the January issue of the journal Chest.

Chest 2001;119:224-227.

-Westport Newsroom 203 319 2700

 
 
 


 
 
 
 
 



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