[The first national program of pediatric lung transplantation: the experience in pediatric intensive care].
OBJECTIVE
The aim of this study was to analyze the postoperative progress and medical management in the Pediatric Intensive Care Unit (PICU) of patients that underwent bilateral lung transplant.


METHODS
From April 1997 to June 1998, 10 pediatric lung transplants were performed at the Hospital Reina Sofía (Córdoba, Spain). There were 4 males and 6 females (mean age 11.5 years, range 5 to 15 years). Indications for transplantation were cystic fibrosis (n = 9) and one pulmonary fibrosis secondary to viral infection. Before the transplant, two patients required mechanical ventilation for acute respiratory decompensation and one patient was ventilator-dependent. Immunosuppression consisted of corticosteroids, azathioprine and cyclosporine or tacrolimus. Post-transplantation management included early extubation, when possible, optimal fluid balance to prevent lung edema, low aggressive mechanical ventilation and adequate treatment of complications, such as rejection and infection.


RESULTS
There were no peri-operative mortalities. The mean stay in the PICU was 28 days (median: 17 days) and the mean time on mechanical ventilation was 19 days (median: 5.5 days). The most frequent complications were rejection (n = 8), hyperglycemia (n = 6), renal failure (n = 4), arterial hypertension (n = 4) and respiratory infections (n = 3). There were no airway complications.


CONCLUSIONS
Even if the post-operative period in pediatric lung transplant patients is difficult, the results have been good with an important improvement in the quality of life of these patients has been achieved.
Servicio de Críticos y Urgencias Pediátricas, Hospital Reina Sofía, Córdoba.
M
M
Frías Pérez
C
C
Montero Schiemann
I
I
Ibarra de la Rosa
E
E
Ulloa Santamaría
J
J
Muñoz Bonet
M
M
Velasco Jabalquinto
J
J
Pérez Navero
R
R
Lama Martínez
F
F
Santos Luna
A
A
Salvatierra Velázquez
J
J
López Pujol
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000706:statistics & numerical data; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D013030:Spain; D016896:Treatment Outcome
Primer programa nacional de trasplante pulmonar infantil: experiencia en cuidados intensivos pediátricos.