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Eur J Anaesthesiol. 2015 Dec;32(12):828-36. doi: 10.1097/EJA.0000000000000291.

How to minimise ventilator-induced lung injury in transplanted lungs: The role of protective ventilation and other strategies.

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From the Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (ASL, PLS, PRMR), Division of Pulmonary and Critical Care Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (YS), and Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, IRCCS AOU San Martino - IST, Genoa, Italy (YS, PP) *Andre Soluri-Martins and Yuda Sutherasan contributed equally to this manuscript.


Lung transplantation is the treatment of choice for end-stage pulmonary diseases. In order to avoid or reduce pulmonary and systemic complications, mechanical ventilator settings have an important role in each stage of lung transplantation. In this respect, the use of mechanical ventilation with a tidal volume of 6 to 8 ml  kg(-1) predicted body weight, positive end-expiratory pressure of 6 to 8 cmH2O and a plateau pressure lower than 30 cmH2O has been suggested for the donor during surgery, and for the recipient both during and after surgery. For the present review, we systematically searched the PubMed database for articles published from 2000 to 2014 using the following keywords: lung transplantation, protective mechanical ventilation, lung donor, extracorporeal membrane oxygenation, recruitment manoeuvres, extracorporeal CO2 removal and noninvasive ventilation.

[Indexed for MEDLINE]

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