Impact of implementing a protocol of respiratory care measures and optimization of mechanical ventilation in potential lung donors

Abstract

Objective: To describe the results from the implementation of a respiratory care and mechanical ventilation protocol on potential lung donors who met the conditions for procurement. The secondary objective is to compare the results with historical data. Methods: This was a retrospective, observational study. It included potential donors suitable for procurement of organs who had brain death and were hospitalized in critical care units of the Autonomous City of Buenos Aires from April 2017 to March 2018. Main variables: number of potential lung donors that reached the objective of procurement, rate of lungs procured, and rate of implanted lungs. Values of p < 0.05 were considered significant. Results: Thirty potential lung donors were included, and 23 (88.5%; 95%CI 69.8 - 97.6) met the oxygenation objective. Twenty potential lung donors donated organs, of whom eight donated lungs, with which four double lung transplants and eight single lung transplants were performed. Seven of 12 lungs were procured and implanted in the preprotocol period, while all 12 were under the protocol (p = 0.38). The implantation rate was 58.3% (7/12) in the historical control period and 100% (12/12) (p = 0.04) in the study period. Conclusion: The protocol allowed us to reach the oxygenation objective in the majority of potential lung donors and yielded a statistically significant improvement in the implantation rate.