Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/169368 |
Resumo: | OBJECTIVE: To report initial experience from the use of extracorporeal membrane oxygenation (ECMO) in patients who received lung transplantation. METHODS: Retrospective study of a single tertiary center in the Brazilian state of Sa˜o Paulo, a national reference in lung transplantation, based on the prospective collection of data from electronic medical records. The period analyzed extended from January 2009 (beginning of the program) until December 2018. RESULTS: A total of 75 lung transplants were performed, with ECMO used in 8 (10.7%) cases. Of the patients, 4 (50%) were female. The mean age was 46.4±14.3 years. The causes of the end-stage lung disease that led to transplantation were pulmonary arterial hypertension in 3 (37.5%) patients, bronchiectasis in 2 (25%) patients, pulmonary fibrosis in 2 (25%) patients, and pulmonary emphysema in 1 (12.5%) patient. In our series, 7 (87.5%) cases were sequential bilateral transplantations. Prioritization was necessary in 4 (50%) patients, and in 1 patient, ECMO was used as a bridge to transplantation. The ECMO route was central in 4 (50%), peripheral venovenous in 2 (25%) and peripheral venoarterial in 2 (25%) patients. The mean length of the intensive care unit (ICU) stay was 14±7.5 days and of the hospital stay was 34.1±34.2 days. The mean ECMO duration was 9.3±6.6 days with a 50% decannulation rate. Three patients were discharged (37.5%). CONCLUSION: Lung transplantation requires complex treatment, and ECMO has allowed extending the indications for transplantation and provided adjuvant support in the clinical management of these patients. |
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Clinics |
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Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian CenterLung TransplantationExtracorporeal Membrane OxygenationHypertensionPulmonaryPulmonary FibrosisHeart FailureDiastolicOBJECTIVE: To report initial experience from the use of extracorporeal membrane oxygenation (ECMO) in patients who received lung transplantation. METHODS: Retrospective study of a single tertiary center in the Brazilian state of Sa˜o Paulo, a national reference in lung transplantation, based on the prospective collection of data from electronic medical records. The period analyzed extended from January 2009 (beginning of the program) until December 2018. RESULTS: A total of 75 lung transplants were performed, with ECMO used in 8 (10.7%) cases. Of the patients, 4 (50%) were female. The mean age was 46.4±14.3 years. The causes of the end-stage lung disease that led to transplantation were pulmonary arterial hypertension in 3 (37.5%) patients, bronchiectasis in 2 (25%) patients, pulmonary fibrosis in 2 (25%) patients, and pulmonary emphysema in 1 (12.5%) patient. In our series, 7 (87.5%) cases were sequential bilateral transplantations. Prioritization was necessary in 4 (50%) patients, and in 1 patient, ECMO was used as a bridge to transplantation. The ECMO route was central in 4 (50%), peripheral venovenous in 2 (25%) and peripheral venoarterial in 2 (25%) patients. The mean length of the intensive care unit (ICU) stay was 14±7.5 days and of the hospital stay was 34.1±34.2 days. The mean ECMO duration was 9.3±6.6 days with a 50% decannulation rate. Three patients were discharged (37.5%). CONCLUSION: Lung transplantation requires complex treatment, and ECMO has allowed extending the indications for transplantation and provided adjuvant support in the clinical management of these patients.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2020-05-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/xmlhttps://www.revistas.usp.br/clinics/article/view/16936810.6061/clinics/2020/e1698Clinics; Vol. 75 (2020); e1698Clinics; v. 75 (2020); e1698Clinics; Vol. 75 (2020); e16981980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/169368/160486https://www.revistas.usp.br/clinics/article/view/169368/160487Copyright (c) 2020 Clinicsinfo:eu-repo/semantics/openAccessPola-dos-Reis, FlávioSamano, Marcos NaoyukiAbdalla, Luis GustavoCarvalho, Guilherme Vieira Soares deFernandes, Lucas MatosGomes-Júnior, OswaldoCarraro, Rafael MedeirosCamargo, Priscila Cilene Leon Bueno deTeixeira, Ricardo Henrique Oliveira BragaAfonso-Júnior, José EduardoPêgo-Fernandes, Paulo Manoel2020-05-03T22:42:19Zoai:revistas.usp.br:article/169368Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2020-05-03T22:42:19Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center |
title |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center |
spellingShingle |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center Pola-dos-Reis, Flávio Lung Transplantation Extracorporeal Membrane Oxygenation Hypertension Pulmonary Pulmonary Fibrosis Heart Failure Diastolic |
title_short |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center |
title_full |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center |
title_fullStr |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center |
title_full_unstemmed |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center |
title_sort |
Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center |
author |
Pola-dos-Reis, Flávio |
author_facet |
Pola-dos-Reis, Flávio Samano, Marcos Naoyuki Abdalla, Luis Gustavo Carvalho, Guilherme Vieira Soares de Fernandes, Lucas Matos Gomes-Júnior, Oswaldo Carraro, Rafael Medeiros Camargo, Priscila Cilene Leon Bueno de Teixeira, Ricardo Henrique Oliveira Braga Afonso-Júnior, José Eduardo Pêgo-Fernandes, Paulo Manoel |
author_role |
author |
author2 |
Samano, Marcos Naoyuki Abdalla, Luis Gustavo Carvalho, Guilherme Vieira Soares de Fernandes, Lucas Matos Gomes-Júnior, Oswaldo Carraro, Rafael Medeiros Camargo, Priscila Cilene Leon Bueno de Teixeira, Ricardo Henrique Oliveira Braga Afonso-Júnior, José Eduardo Pêgo-Fernandes, Paulo Manoel |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Pola-dos-Reis, Flávio Samano, Marcos Naoyuki Abdalla, Luis Gustavo Carvalho, Guilherme Vieira Soares de Fernandes, Lucas Matos Gomes-Júnior, Oswaldo Carraro, Rafael Medeiros Camargo, Priscila Cilene Leon Bueno de Teixeira, Ricardo Henrique Oliveira Braga Afonso-Júnior, José Eduardo Pêgo-Fernandes, Paulo Manoel |
dc.subject.por.fl_str_mv |
Lung Transplantation Extracorporeal Membrane Oxygenation Hypertension Pulmonary Pulmonary Fibrosis Heart Failure Diastolic |
topic |
Lung Transplantation Extracorporeal Membrane Oxygenation Hypertension Pulmonary Pulmonary Fibrosis Heart Failure Diastolic |
description |
OBJECTIVE: To report initial experience from the use of extracorporeal membrane oxygenation (ECMO) in patients who received lung transplantation. METHODS: Retrospective study of a single tertiary center in the Brazilian state of Sa˜o Paulo, a national reference in lung transplantation, based on the prospective collection of data from electronic medical records. The period analyzed extended from January 2009 (beginning of the program) until December 2018. RESULTS: A total of 75 lung transplants were performed, with ECMO used in 8 (10.7%) cases. Of the patients, 4 (50%) were female. The mean age was 46.4±14.3 years. The causes of the end-stage lung disease that led to transplantation were pulmonary arterial hypertension in 3 (37.5%) patients, bronchiectasis in 2 (25%) patients, pulmonary fibrosis in 2 (25%) patients, and pulmonary emphysema in 1 (12.5%) patient. In our series, 7 (87.5%) cases were sequential bilateral transplantations. Prioritization was necessary in 4 (50%) patients, and in 1 patient, ECMO was used as a bridge to transplantation. The ECMO route was central in 4 (50%), peripheral venovenous in 2 (25%) and peripheral venoarterial in 2 (25%) patients. The mean length of the intensive care unit (ICU) stay was 14±7.5 days and of the hospital stay was 34.1±34.2 days. The mean ECMO duration was 9.3±6.6 days with a 50% decannulation rate. Three patients were discharged (37.5%). CONCLUSION: Lung transplantation requires complex treatment, and ECMO has allowed extending the indications for transplantation and provided adjuvant support in the clinical management of these patients. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-05-03 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/169368 10.6061/clinics/2020/e1698 |
url |
https://www.revistas.usp.br/clinics/article/view/169368 |
identifier_str_mv |
10.6061/clinics/2020/e1698 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/169368/160486 https://www.revistas.usp.br/clinics/article/view/169368/160487 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/xml |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 75 (2020); e1698 Clinics; v. 75 (2020); e1698 Clinics; Vol. 75 (2020); e1698 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222765034242048 |