masterThesis
Factores asociados al uso de Asistencia Ventricular Intraoperatoria en Trasplante Pulmonar en la Fundación Cardioinfantil, Bogotá - Colombia. Experiencia de 5 años
Fecha
2019Autor
Gutiérrez Soriano, Laura Patricia
Institución
Resumen
Background: Extracoporeal assistance in Lung Transplantation is routinely used in many centers around the world. In those who do not, it is estimated that about 30-40% of patients will require some type of extracorporeal assistance. It is important to determine in advance what is the most relevant criteria for the use of extracorporeal assistance in Lung Transplantation. Methods: The medical records of patients who undergo Lung Transplant were review from January 2014 to May 2019 (n=29). Data from the pre-transplant assessment were also taken, including walk test, arterial blood gases and biventricular function. Data at the beginning of the surgery like biventricular function, pulmonary artery pressure and arterial blood gas were recorded on the process. The transoperative variations of these variables and the metabolic impact of the used of ventricular assistance were also recorded. Demographic and characteristics were described with measures of central tendency. An analysis was performed to determine the most important factor for the use of extracorporeal assistance in Lung Transplantation. Results: The 20.6% of the patients had echocardiographic changes in the right ventricular function at the time of induction in regards to the pre-surgical echocardiography. All the patients with moderate or severe right ventricular dysfunction at the beginning of surgery required intraoperative ventricular assistance and also had metabolic compromise with higher lactate. Conclusions: The most important thing to decide intraoperative ventricular assistance in Lung Transplantation is the moderate or severe compromise of the right ventricular function evaluated by transesophageal echocardiography after anesthetic induction.