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Experience in the use of bronchofibroscopy in the treatment for acute lung injury after liver transplantation

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Author:
No author available
Journal Title:
CHINESE CRITICAL CARE MEDICINE
Issue:
5
DOI:
10.3321/j.issn:1003-0603.2008.05.005
Key Word:
纤维支气管镜;肝移植,肺损伤;急性;回顾性研究;bronchofibroscope;liver transplantation;acute lung injury;retrospective study

Abstract: Objective To evaluate retrospectively the clinical therapeutic effects of the application of bronchofibroscopy(BFS) in the treatment of acute lung injury (ALI) after liver transplantation. Methods Fifty-eight patients with ALI caused by various kinds of reasons after liver transplantation were divided into two groups depending on whether the BFS was undertaken (group A, n= 36) or not (group B, n= 22), and the clinical therapeutic effects were evaluated by comparing the length of intensive care unit (ICU) stay and mechanical ventilation, mortality rate of ALI, morbidity and mortality rate of acute respiratory distress syndrome (ARDS) and changes in arterial blood gas analysis before and after BFS treatment. Results The length of ICU stay [(11±4) days vs. (16±4) days] and mechanical ventilation [(9±5) days vs. (14±5) days, both P<0. 01] in group A were shorter, and mortality rate of ALI (11.1% vs. 36.4%), morbidity rate (27.8% vs. 54.5%, P<0.05 and P<0. 01) and mortality rate of ARDS [40. 0% (4/10) vs. 66.7% (8/12)] were lower in group A compared with group B (P>0. 05). Arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), arterial oxygen saturation (SaO2), and oxygenation index (PaO2/FiO2) after treatment were much better than those before BFS in group A and the differences were significant (all P<0. 01). Conclusion BFS is a kind of safe and effective treatment measure for ALI after liver transplantation and is worthwhile to recommend.

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