Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplantation: First Polish Experience.

BACKGROUND: Lung transplantation remains the only viable option for patients with end-stage lung diseases. However, due to an insufficient number of lung donors, many potential candidates die without undergoing the procedure. In the cases of some patients, bridges to transplantation can be implemented. One such method is extracorporeal membrane oxygenation (ECMO), which, depending on the type, has the ability to replace patients' circulatory and respiratory function. CASE PRESENTATION: This case study describes 4 cases of patients, who were successfully bridged to lung transplantation. The first patient developed respiratory failure as a result of acute pulmonary embolisms. His respiratory function was insufficient and he had ECMO implanted for 84 days until he was transplanted. Another patient presented respiratory failure due to massive bleeding, which occurred during transbronchial lung biopsy. Such event led to extensive exacerbation, which resulted in using ECMO as a bridge to recovery at first, but later a bridge to lung transplantation. The patient became a lung graft recipient after 14 days on ECMO. The third patient was a woman who developed severe respiratory failure during the course of the progression of her underlying disease. She was treated with ECMO for 14 days as well, and she also underwent lung transplantation. The fourth patient was qualified for retransplantation. She was bridged to retransplantation via veno-venous ECMO. CONCLUSION: ECMO can be used a bridge to lung transplantation for suitable patients even for a long period of time, given that it is maintained in accordance with the guidelines.

[Preoperative analysis of vital lung capacity in female patients with flattened thyrotoxicosis]. / Przedoperacyjna ocena pojemnosci zyciowej pluc u kobiet z nadczynnoscia tarczycy w stadium eutyreozy.

Unbalanced hyperthyroidism leads to the feeling of dyspnea and to the decrease of vital lung capacity. Efficacious treatment of thyrotoxicosis relieves mentioned disorders and brings normalization of ventilation parameters. The main issue of this research was the analysis of vital lung capacity in female patients with properly treated hyperthyroidism and comparison of values of these parameters among patients with balanced thyrotoxicosis, non-toxic goitre and with non-thyroid disorders. Research was conducted on 300 randomized female-patients (ASA I, II), aged 18 to 47 with surgically treated hyperthyroidism, non-toxic goitre or non-thyroid disorders. Vital lung capacity (VLC) was analyzed as absolute values and as a percent of predicted values. Statistical analysis revealed that patients in specified groups did not differ in age, weight and frequency of belonging to both ASA categories. Vital lung capacity and percent of predicted values were not significantly different in all groups. Vital lung capacity of female-patients with balanced hyperthyroidism did not differ significantly from vital lung capacity of patients with non-toxic goitre and non-thyroid disorders.