Author/Authors :
Ramanathan, Kollengode The Critical Care Research Group - The Prince Charles Hospital and the University of Queensland, Brisbane, Australia , Mohammed, Hend The Critical Care Research Group - The Prince Charles Hospital and the University of Queensland, Brisbane, Australia , Hopkins, Peter The Critical Care Research Group - The Prince Charles Hospital and the University of Queensland, Brisbane, Australia , Corley, Amanda The Critical Care Research Group - The Prince Charles Hospital and the University of Queensland, Brisbane, Australia , Caruana, Lawrence The Critical Care Research Group - The Prince Charles Hospital and the University of Queensland, Brisbane, Australia , Dunster, Kimble The Critical Care Research Group - The Prince Charles Hospital and the University of Queensland, Brisbane, Australia , Barnett, Adrian G. Institute of Health and Biomedical Innovation - Queensland University of Technology, Kelvin Grove, Australia , Fraser, John F. The Critical Care Research Group - The Prince Charles Hospital and the University of Queensland, Brisbane, Australia
Abstract :
Background. Lung transplantation is the optimal treatment for end stage lung disease. Donor shortage necessitates single-lung
transplants (SLT), yet minimal data exists regarding regional ventilation in diseased versus transplanted lung measured by Electrical
Impedance Tomography (EIT). Method. We aimed to determine regional ventilation in six SLT outpatients using EIT. We assessed
end expiratory volume and tidal volumes. End expiratory lung impedance (EELI) and Global Tidal Variation of Impedance were
assessed in supine, right lateral, left lateral, sitting, and standing positions in transplanted and diseased lungs. A mixed model
with random intercept per subject was used for statistical analysis. Results. EELI was significantly altered between diseased and
transplanted lungs whilst lying on right and left side. One patient demonstrated pendelluft between lungs and was therefore
excluded for further comparison of tidal variation. Tidal variation was significantly higher in the transplanted lung for the remaining
five patients in all positions, except when lying on the right side. Conclusion. Ventilation to transplanted lung is better than diseased
lung, especially in lateral positions. Positioning in patients with active unilateral lung pathologies will be implicated. This is the first
study demonstrating changes in regional ventilation, associated with changes of position between transplanted and diseased lung.
