脑死亡器官捐赠供肺保护及通气管理2例报道  

Lung protective and ventilatory management strategies in potential lung donor patients after brain death： report of two cases

作　　者：葛慧青[1] 沈晔[2] 陈静瑜[3] 段开亮[1] 桑贤印 张美齐[2] 蔡文伟[2] 

机构地区：[1]浙江大学医学院附属邵逸夫医院呼吸治疗科,杭州310016 [2]浙江省人民医院急诊科 [3]南京医科大学附属无锡市人民医院 江苏省器官移植重点实验室

出　　处：《中华器官移植杂志》2015年第5期265-270,共6页Chinese Journal of Organ Transplantation

基　　金：江苏省第四期“3332”工程基金（BRA208026）

摘　　要：目的探讨肺维护及通气策略对脑死亡潜在供肺移植前的肺保护以及对移植肺术后肺功能的疗效。方法分析2015年2月至2015年3月2例脑死亡器官捐赠供者供肺保护通气策略的临床资料。2例供者均为外伤致脑死亡患者。分别经肺保护通气及气道管理9d及4d，评估氧和、影像学改变、供肺获取及术后受者肺康复情况。结果两例扩大标准供肺均被成功获取，两例受者双肺移植术后肺功能明显改善，成功撤离呼吸机。结论脑死亡捐赠供肺经有效维护及肺保护通气策略有利于提高肺移植效果。Objective To investigate the effect of lung protective and ventilatory management strategies for brain death donors on eligibility and availability of lungs for transplantation. Method The clinical data of two brain dead patients who accepted lung protective ventilatory management strategies from Feb. 2015 to Mar. 2015 were retrospectively analyzed. Two cases of brain-dead patients, due to severe cerebral trauma, accepted the aggressive lung protective ventilatory management strategies and airway management for 9 days and 4 days respectively. PaO2/Fi02, chest imaging manifestations, surface of the lung harvested and pulmonary rehabilitation of recipients after operation were observed. Result Two lung recipients were liberated from ventilation and pulmonary function improved significantly after double lung transplantation. Conclusion The application of lung protective ventilatory strategies in potential organ donors with brain death can increase the number of eligible and harvested lungs.

关 键 词：脑死亡 供者 器官捐赠 肺移植 肺保护通气 

分 类 号：R617[医药卫生—外科学]