Single-lung transplant recipients can be safely turned during postop period

NEW YORK (Reuters Health) – Turning a single-lung transplant patient during the immediate postoperative period does not appear to compromise oxygenation or hemodynamic status, reports a team of researchers in Pittsburgh.

Dr. Elisabeth L. George, of the University of Pittsburgh Health System, and colleagues recruited 15 adult recipients of a single-lung transplant who were hemodynamically stable. During the first 24 hours after surgery, patients were allocated to one of three groups, each of which included two patients with a primary diagnosis of fibrosis and three with emphysema.

Each group differed by sequence in which they were turned, where body positions were supine, lateral with allograft lung down, and lateral with native lung down. Four patients received differential lung ventilation, and 11 received synchronized intermittent mandatory ventilation.

As reported in the American Journal of Critical Care for January, changes in oxygenation, ventilation, and blood flow were independent of patient position or diagnosis. Patients reported minimal discomfort after being turned.

"The research findings support the application of standard nursing practice to reposition a critically ill patient every 1 to 2 hours," Dr. George and her associates conclude. They recommend, however, that patients be monitored for changes in oxygenation after being positioned.

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