title: Efficacy of recruitment maneuver for improving the brain dead marginal lungs to ideal.
abstract: BACKGROUND
  Because of the shortage of lungs for transplantation, finding the suitable lungs in brain-dead donors is an important issue. Recruitment maneuver is a strategy aimed at re-expanding collapsed and edematous lung tissue. The aim of this study was to assess the efficacy of this maneuver on improving marginal lungs for transplantation.
  
  
  METHODS
  From 127 brain-dead potential donor which were evaluated for lung donation in Masih Daneshvari Organ Procurement Unit of Tehran, Iran, 31 (25%) had marginal lungs for transplantation. These donors had normal chest X ray or bilateral infiltration and had PaO2 200-300 mm Hg with FIO2 100%. The recruitment maneuver was performed and arterial blood gas was obtained before and after maneuver. The maneuver lasts for 2 hours with continuous check of O2 saturation and patient's hemodynamic during. Finally, patients with normal bronchoscopy and PaO2/FIO2 >300 mm Hg were considered good candidates for lung transplantation. The frequency (%) and mean ± SD were used for description of variables and the Wilcoxon test was used for comparison between pre- and post-maneuver PaO2 with FIO2 100%.
  
  
  RESULTS
  The mean ± SD of PaO2/FIO2 with 100% FIO2 of patients before and after recruitment were 239 ± 62 and 269 ± 91, respectively. Recruitment maneuver could convert 10 marginal lungs (32%) to appropriate ones (PaO2 > 300) and finally 8 lungs were transplanted.
  
  
  CONCLUSIONS
  Findings of this study showed that recruitment maneuver could convert inappropriate lungs to appropriate ones in one third of brain-dead patients who had marginal lung condition. So, it is recommended that this maneuver is considered in the assessment protocol of lungs for donation.
authors: Lung Transplantation Research Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: S
authors: S
authors: Parto
authors: S
authors: S
authors: Shafaghi
authors: H-R
authors: HR
authors: Khoddami-Vishteh
authors: S Mohammad
authors: SM
authors: Makki
authors: A
authors: A
authors: Abbasidezfuli
authors: A
authors: A
authors: Daneshvar
authors: K
authors: K
authors: Sheikhy
authors: J
authors: J
authors: Faeghi
authors: F
authors: F
authors: Ghorbani
authors: T
authors: T
authors: Parsa
authors: K
authors: K
authors: Najafizadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D001784:Blood Gas Analysis; D001926:Brain Death / Q000503:physiopathology*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007492:Iran; D008168:Lung / Q000503:physiopathology / Q000601:surgery*; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D011446:Prospective Studies; D001261:Pulmonary Atelectasis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011654:Pulmonary Edema / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012121:Respiration, Artificial / Q000379:methods*; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D055815:Young Adult