Introduction: To explore the hypothesis that early ventilation strategies influence clinical outcomes in lung transplantation, we have examined our routine ventilation practices in terms of tidal volumes (Vt) and inflation pressures. Methods: A total of 124 bilateral lung transplants between 2010 and 2013 were retrospectively assigned to low (b6 mL/kg), medium (6-8 mL/kg), and high (N8 mL/kg) Vt groups based on ventilation characteristics during the first 6 hours after surgery. Those same 124 patients were also stratified to low-pressure (b25 cm H2O) and high-pressure (≥25 cm H2O) groups. Results: Eighty percent of patients were ventilated using pressure control mode. Low, medium, and high Vt were applied to 10%, 43%, and 47% of patients, respectively. After correcting for patients requiring extracorporeal support, there was no difference in short-term to midterm outcomes among the different Vt groups. Low inflation pressures were applied to 61% of patients, who had a shorter length of intensive care unit stay (5 vs 12 days; P = .012), higher forced expiratory volume in 1 second at 3 months (77.8% vs 60.3%; P b .001), and increased 6-month survival rate (95% vs 77%; P = .008). Conclusion: Low Vt ventilation has not been fully adopted in our practice. Ventilation with higher inflation pressures, but not Vt, was significantly associated with poorer outcomes after lung transplantation.
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机译：简介：为了探讨早期通气策略会影响肺移植临床结果的假设，我们从潮气量（Vt）和充气压力方面检查了常规通气实践。方法：根据2010年至2013年期间的通气特征，回顾性将124例双侧肺移植患者分为低（b6 mL / kg），中（6-8 mL / kg）和高（N8 mL / kg）Vt组。手术后的前6个小时。相同的124位患者也分为低压（b25 cm H2O）和高压（≥25cm H2O）组。结果：80％的患者使用压力控制模式通气。低，中和高Vt分别应用于10％，43％和47％的患者。校正需要体外支持的患者后，不同的Vt组之间的短期至中期结局无差异。低通气压力应用于61％的重症监护病房住院时间较短的患者（5天比12天； P = .012），在3个月内1秒内较高的强制呼气量（77.8％对60.3％； （P b .001），并提高了6个月生存率（95％比77％； P = .008）。结论：低Vt通气在我们的实践中尚未得到充分采用。通气与较高的通气压力而不是Vt显着相关，其与肺移植后预后较差有关。
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