ICU Care Before and After Lung Transplantation

Area of Science:

• Critical care medicine
• Thoracic surgery
• Pulmonary medicine

Background:

• Lung transplantation (LTx) is a vital treatment for end-stage lung disease.
• Mechanical respiratory support is increasingly important for LTx candidates and post-transplant care.
• Innovations in extracorporeal life support (ECLS) have expanded its application.

Purpose of the Study:

• To review the role of mechanical respiratory support in lung transplantation.
• To discuss critical care management of LTx candidates and recipients.
• To highlight challenges and outcomes related to bridging and postoperative complications.

Main Methods:

• Review of retrospective studies on mechanical respiratory support as a bridge to LTx.
• Analysis of critical care interventions in LTx management.
• Examination of outcomes related to primary graft dysfunction and ECLS post-LTx.

Main Results:

• Mechanical respiratory support, including ECLS, shows promising outcomes as a bridge to LTx.
• Bridging remains technically and ethically challenging, influencing selection criteria.
• Primary graft dysfunction and prolonged ventilation are key obstacles to survival post-LTx.

Conclusions:

• Mechanical respiratory support plays a critical role throughout the lung transplantation journey.
• Further evidence is needed for optimal ventilation and management post-LTx.
• Prolonged ECLS may benefit selected patients with primary graft dysfunction.