[The treatment strategy of early ALI after liver transplantation].
OBJECTIVE
To investigate the treatment strategy of early acute lung injury (ALI) after liver transplantation.


METHODS
18 patients complicated with ALI after liver transplantation were given comprehensive therapies and two minutes of recruitment maneuver (RM) to open previously collapsed lung units and then lung protective ventilatory strategy within 3 hours of hypoxemia. The inspiratory pressure was 25 cm H2O and PEEP 17 cm H2O. Optimal PEEP were maintained after RM to stabilize lung volume.


RESULTS
The PaO(2), SaO(2) and PaO(2)/FiO(2) of all 18 patients were improved greatly. RM was effective in 17 patients except one case of severe pulmonary infection, whose PaO(2)/FiO(2) was only improved by 40%. PaO(2), SaO(2) and PaO(2)/FiO(2) were increased by 68 mm Hg, 9.5%, and 104.7% respectively. And the improved oxygenation can be maintained 2 - 24 hours. The effective rate of RM was 94.4%. All 18 patients were weaned and extubated successfully with the survival rate of 100%. RM was well tolerated without complications.


CONCLUSIONS
ALI post liver transplantation should be diagnosed and treated in early stage. RM combined with lung protective ventilatory strategy is a safe and effective treatment for early ALI after liver transplantation.
Yi
Hui-min
HM
Liver Tansplantation Center, Third Affiliated Hospital, Sun Yat-sen University, Transplantation Research Institute of Sun Yat-sen University, Guangzhou 510630, China.
Cai
Chang-jie
CJ
Lu
Min-qiang
MQ
Wang
Gen-shu
GS
Yi
Shu-hong
SH
Yang
Yang
Y
Xu
Chi
C
Li
Hua
H
Chen
Gui-hua
GH
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011183:Postoperative Complications / Q000628:therapy*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*