Lung Transplantation Clinical Trial
Official title:
Normothermic Ex-vivo Lung Perfusion: Clinical Experience of the Pressure/Time Curve Profile Study (Stress Index)
In order to minimize mechanical stress the investigators propose to implement EVLP procedure with a ventilation monitoring guided by the analysis of the Paw-t shape.
Increase of interest about technique of Ex-Vivo Lung Perfusion (EVLP) has highlighted the
need of new approaches to respiratory mechanics monitoring to prevent lung stress in
atypical physiological settings.
Airway pressure/time curve (Paw-t) shape analysis at constant flow ventilation (Stress
Index, SI) is thought to be predictor of lung stress; so the SI coefficient may therefore
identify and quantify mechanical stress during ventilation. (1) In experimental studies, the
threshold values for SI that best discriminated lungs with signs of Ventilator Induced Lung
Injury ranged between 0.9 and 1.1. (2) During EVLP, the isolated lungs are free from the
effect of chest wall impairment and represent the effective response of lung parenchyma to
ventilatory setting.
Use of SI monitoring in isolated and perfuse lung reconditioning, may be an useful tool to
prevent hyperinflation and opening-closing conditions by titrating optimal protective
ventilation As previously reported by our group, in the first trial of lung reconditioning,
signs of mechanical stress were detected with Paw-t curve. (3) Therefore we implemented EVLP
procedure with continuous stress index analysis to detect and quantify the occurrence of
hyperinflation or opening closing condition.
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Time Perspective: Prospective
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