Postoperative Management

Intensive Care Unit Monitoring

All lung transplant patients are admitted post-operatively to the intensive care unit, where monitoring includes the following: Electrocardiogram, oximetric evaluation of arterial and mixed venous oxygen saturation, and continuous monitoring of systemic and pulmonary arterial pressures.


Most patients arrive in the intensive care unit mechanically ventilated through a single lumen endotracheal tube, which is preferable for pulmonary toilet. After BLT or SLT for IPF, standard ventilatory parameters are used. The FIO2 is kept at a level to maintain a Pa02 greater than 70 mmHg. A tidal volume of 8 to 12 ml/kg is usually sufficient. Extubation is performed once satisfactory gas exchange and lung mechanics are accomplished. Most of these patients are extubated between 24 and 48 hours following transplantation.

Patients who have undergone SLT for COPD or pulmonary hypertension are managed differently.30 In patients with COPD, PEEP is avoided and tidal volumes

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