Safety of hyperbaric oxygen therapy for management of central airway stenosis after lung transplant.
Safety of hyperbaric oxygen therapy for management of central airway stenosis after lung transplant.
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DOI：
10.1111/ctr.12798
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发表时间：
2016-09
影响因子：
2.1
通讯作者：
Shofer SL
中科院分区：
文献类型：
--
作者：
Mahmood K;Kraft BD;Glisinski K;Hartwig MG;Harlan NP;Piantadosi CA;Shofer SL
中心气道狭窄（CAS）是肺移植术后常见的并发症，可导致严重的移植后并发症。它通常发生在广泛的气道坏死之前，与气道缺血有关。高压氧治疗（HBOT）对缺血移植物是有用的，并可能减少CAS的发展。本研究的目的是确定HBOT是否可以安全地用于肺移植患者广泛的坏死气道斑块。其次，我们评估了HBOT对CAS发生率和严重程度的影响。肺移植后1-2个月内出现广泛坏死气道斑块的患者在标准治疗的同时接受HBOT沿着治疗。将这些患者与同期具有相似斑块但未接受HBOT的参照组进行比较。10例患者在移植后40.5（IQR 34-54）天开始接受HBOT治疗18.5（四分位距，IQR 11-20）次。HBOT耐受性良好。高压氧治疗组和对照组的CAS发生率相似（分别为70%和87%; P= 0.34），但高压氧治疗组需要的支架较少（分别为10%和56%; P= 0.03）。这项初步研究首次证明了HBOT在肺移植后出现坏死气道斑块的患者中的安全性。HBOT可减少CAS患者气道支架置入的需要。
Central airway stenosis (CAS) is common after lung transplantation and causes significant post-transplant morbidity. It is often preceded by extensive airway necrosis, related to airway ischemia. Hyperbaric oxygen therapy (HBOT) is useful for ischemic grafts and may reduce the development of CAS. The purpose of this study was to determine whether HBOT could be safely administered to lung transplant patients with extensive necrotic airway plaques. Secondarily, we assessed any effects of HBOT on the incidence and severity of CAS. Patients with extensive necrotic airway plaques within 1–2 months after lung transplantation were treated with HBOT along with standard care. These patients were compared with a contemporaneous reference group with similar plaques who did not receive HBOT. Ten patients received HBOT for 18.5 (interquartile range, IQR 11–20) sessions, starting at 40.5 (IQR 34–54) days after transplantation. HBOT was well tolerated. Incidence of CAS was similar between HBOT-treated patients and reference patients (70% vs 87%, respectively; P=.34), but fewer stents were required in HBOT patients (10% vs 56%, respectively; P=.03). This pilot study is the first to demonstrate HBOT safety in patients who develop necrotic airway plaques after lung transplantation. HBOT may reduce the need for airway stent placement in patients with CAS.
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影响因子：
3.4
作者：
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通讯作者：
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