scholarly journals Smoking Mechanics and Impact on Smoking Cessation: Two Cases of Smoking Lapse Status Post Lung Transplantation

2022 ◽  
Vol 15 ◽  
pp. 1179173X2110696
Author(s):  
Panagis Galiatsatos ◽  
Princess Ekpo ◽  
Raiza Schreiber ◽  
Lindsay Barker ◽  
Pali Shah
Keyword(s):  
Lung Transplantation ◽  
Lung Transplant ◽  
Transplant Patient ◽  
Smoking Behavior ◽  
Lung Mechanics ◽  
Chronic Obstructive ◽  
Behavior Changes ◽  
Post Transplantation ◽  
Obstructive Pulmonary Disease ◽  
Tobacco Usage

Background Smoking behavior includes mechanisms taken on by persons to adjust for certain characteristic changes of cigarettes. However, as lung function declines due to lung-specific diseases, it is unclear how mechanical smoking behavior changes affect persons who smoke. We review two cases of patients who stopped smoking prior to and then subsequently resumed smoking after lung transplantation. Methods A retrospective review of two patients who were recipients of lung transplantation and sustained from cigarette usage prior to transplantation. Results Patient A was a 54-year-old woman who received a double lung transplant secondary to chronic obstructive pulmonary disease (COPD) in October 2017. She had stopped smoking cigarettes in July 2015 (FEV1 .56 L). Patient B was a 40-year-old man who received a double lung transplantation due to sarcoidosis in January 2015. He stopped smoking cigarettes in February 2012 (FEV1 1.15 L). Post-transplant, Patient A resumed smoking on March 2018 where her FEV1 was at 2.12 L (5 months post-transplantation), and Patient B resumed smoking in April 2017 where his FEV1 was 2.37 L (26 months post-transplantation). Conclusion We report on two patients who resumed smoking after lung transplantation. While variations of smoking mechanics have been identified as a function of nicotine yield and type of cigarette, it lung mechanics may play a role in active smoking as well. Therefore, proper screening for tobacco usage post-lung transplantation should be considered a priority in order to preserve transplanted lungs.

scholarly journals INTERVENTIONAL PULMONARY ASSISTANCE (iLA) AS A BRIDGE TO LUNG TRANSPLANTATION

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
N Burgos Frías ◽  
M Córdoba Peláez ◽  
A Sánchez Calle ◽  
J L Campo Cañaveral ◽  
D Martínez López ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Mechanically Ventilated ◽  
Number Of Patients ◽  
Interventional Lung Assist ◽  
Respiratory Assistance ◽  
Mean Time

Abstract INTRODUCTION According to the “International Society for Heart and Lung Transplantation” (ISHLT), between 1 and 4% of patients awaiting a lung transplant will need some type of respiratory assistance as a bridge to transplantation. The objective of this study is to analyze the results of patients assisted with the iLA “Interventional Lung Assist” system (Novalung®). MATERIAL AND METHODS The iLA respiratory assistance system (Novalung®) has been used in 12 patients as a bridge to lung transplantation (three chronic obstructive pulmonary disease, five obliterative bronchiolitis, two pulmonary fibrosis, one chest trauma, one pulmonary leiomyomatosis). The gasometric parameters that indicated the assistance were: PaO2: 76.1 ± 29; PaCO2: 110.6 ± 49; pH: 7.12 ± 0.1. The patients were anticoagulated with intravenous sodium heparin (aPTT 160-180 seconds). RESULTS Six hours after the start of respiratory assistance, the gasometric parameters were: PaO2: 89 ± 17 (p > 0.05); PaCO2: 54.6 ± 5 (p < 0.05); pH 7.34 ± 0.1 (p < 0.05). The mean time of attendance was 16.8 ± 8 (4-28) days. Of the total number of patients attended: one died during the care and the remaining 11 were transplanted, of which 8 survived the lung transplant. CONCLUSIONS Respiratory assistance using iLA (Novalung®) has proven to be an effective method as a bridge to lung transplantation. It allows to improve lung function and avoid mechanical ventilation. It is indicated in patients with nonpermissive hypercapnia to avoid mechanical ventilation. In mechanically ventilated patients, iLA assistance improves ventilator tidal volume, FiO2 and PEEP.

Artificial lungs: a new inspiration

Perfusion ◽  
2002 ◽  
Vol 17 (4) ◽  
pp. 253-268 ◽  
Author(s):  
Joseph B Zwischenberger ◽  
Scott K Alpard
Keyword(s):  
Lung Transplantation ◽  
Lung Transplant ◽  
Current Treatment ◽  
Chronic Obstructive ◽  
Bridge To Transplantation ◽  
Assist Device ◽  
Ventricular Assist ◽  
Obstructive Pulmonary Disease ◽  
Bridge To Transplant ◽  
Support Device

An estimated 16 million Americans are afflicted with some degree of chronic obstructive pulmonary disease (COPD), accounting for 100,000 deaths per year. The only current treatment for chronic irreversible pulmonary failure is lung transplantation. Since the widespread success of single and double lung transplantation in the early 1990s, demand for donor lungs has steadily outgrown the supply. Unlike dialysis, which functions as a bridge to renal transplantation, or a ventricular assist device (VAD), which serves as a bridge to cardiac transplantation, no suitable bridge to lung transplantation exists. The current methods for supporting patients with lung disease, however, are not adequate or efficient enough to act as a bridge to transplantation. Although occasionally successful as a bridge to transplant, ECMO requires multiple transfusions and is complex, labor-intensive, time-limited, costly, non-ambulatory and prone to infection. Intravenacaval devices, such as the intravascular oxygenator (IVOX) and the intravenous membrane oxygenator (IMO), are surface area limited and currently provide inadequate gas exchange to function as a bridge-to-recovery or transplant. A successful artificial lung could realize a substantial clinical impact as a bridge to lung transplantation, a support device immediately post-lung transplant, and as rescue and//or supplement to mechanical ventilation during the treatment of severe respiratory failure.

Lung transplantation

2010 ◽  
pp. 3476-3485
Author(s):  
P. Hopkins ◽  
K. McNeil
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cystic Fibrosis ◽  
Lung Transplantation ◽  
Therapeutic Option ◽  
Pulmonary Vascular Disease ◽  
Chronic Obstructive ◽  
Solid Organ ◽  
Obstructive Pulmonary Disease ◽  
Substance Addiction ◽  
Recipient Selection

Lung transplantation offers the only therapeutic option for many patients with a variety of endstage pulmonary and cardiopulmonary diseases, but donors are scarce and the major challenge facing lung transplantation (as with all solid organ transplants) is the critical shortage of donor organs. Recipient selection—emphysema/chronic obstructive pulmonary disease (COPD), cystic fibrosis, idiopathic pulmonary fibrosis, and pulmonary vascular disease are the main disease groups referred for lung transplantation. Most patients are listed for transplantation when their survival is estimated to be less than 2 years without a transplant. Exclusion criteria include malignancy (excluding localized skin malignancies) within the last 2 years, inability to cooperate or comply with medical therapy/instruction, recent substance addiction, active or noncurable extrapulmonary infection, significant chest wall/spinal deformity, and significant extrathoracic organ dysfunction....

scholarly journals Chronic Obstructive Pulmonary Disease and the Optimal Timing of Lung Transplantation

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 646
Author(s):  
Vazquez Guillamet
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Lung Transplantation ◽  
Pulmonary Disease ◽  
Survival Benefit ◽  
Optimal Timing ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Systemic Manifestations ◽  
Transplantation Procedures

Chronic obstructive pulmonary disease (COPD) accounts for the largest proportion ofrespiratory deaths worldwide and was historically the leading indication for lung transplantation.The success of lung transplantation procedures is measured as survival benefit, calculated assurvival with transplantation minus predicted survival without transplantation. In chronicobstructive pulmonary disease, it is difficult to show a clear and consistent survival benefit.Increasing knowledge of the risk factors, phenotypical heterogeneity, systemic manifestations, andtheir management helps improve our ability to select candidates and list those that will benefit themost from the procedure.

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