Our Summary

This research paper discusses the serious issue of patient deaths while waiting for lung transplants, mainly due to the shortage of donor organs. The paper explores the potential use of a treatment method known as “awake” extracorporeal membrane oxygenation (ECMO) to help these patients. ECMO is a technique that oxygenates a patient’s blood outside the body, effectively taking over the function of the heart and lungs. The “awake” ECMO method is seen as potentially beneficial because it offers some advantages over mechanical ventilation. The paper reviews relevant studies and discusses when and how to use awake ECMO, as well as possible complications, and aspects that nurses need to consider when caring for these patients.

FAQs

  1. What is “awake” extracorporeal membrane oxygenation (ECMO) and how does it benefit patients awaiting lung transplant?
  2. What are the indications and potential complications of awake ECMO therapy?
  3. What are the specific nursing considerations for patients on awake ECMO therapy awaiting lung transplant?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lung transplant is to closely follow all post-transplant care instructions, including taking prescribed medications, attending follow-up appointments, and participating in pulmonary rehabilitation to optimize lung function and overall health. It is also important to avoid exposure to smoke, pollutants, and other respiratory irritants to reduce the risk of complications and rejection of the transplanted lung. Regular exercise and maintaining a healthy lifestyle can also help improve overall lung function and quality of life post-transplant.

Suitable For

Patients who are typically recommended for lung transplant are those with end-stage lung disease, such as:

  1. Chronic obstructive pulmonary disease (COPD)
  2. Idiopathic pulmonary fibrosis
  3. Cystic fibrosis
  4. Alpha-1 antitrypsin deficiency
  5. Pulmonary hypertension
  6. Bronchiectasis
  7. Interstitial lung disease

These patients have severe and irreversible lung damage that significantly impacts their quality of life and prognosis. Lung transplant may be recommended when other treatments, such as medications or oxygen therapy, are no longer effective in managing their condition. Additionally, patients must meet specific criteria for lung transplant, including being physically fit enough to undergo the surgery and commit to post-transplant care.

Timeline

Before lung transplant:

  • Patient is diagnosed with end-stage lung disease and referred for evaluation for lung transplant
  • Patient undergoes extensive evaluation to determine eligibility for transplant, including medical, psychological, and social assessments
  • Patient is placed on the waiting list for a donor organ
  • Patient may experience worsening symptoms and functional decline while waiting for a transplant
  • Patient may require supplemental oxygen, medications, and other treatments to manage their condition

After lung transplant:

  • Patient undergoes surgery to receive a new lung or lungs
  • Patient is closely monitored in the intensive care unit (ICU) immediately post-transplant
  • Patient may experience complications such as rejection, infection, and organ failure
  • Patient undergoes rehabilitation and physical therapy to regain strength and function
  • Patient is closely followed by a multidisciplinary team of healthcare providers for long-term care and management of their new organ
  • Patient may experience improvements in symptoms, quality of life, and overall health after transplant.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a lung transplant?
  2. How long is the waiting list for a lung transplant and what factors determine priority for receiving a donor organ?
  3. What is the success rate of lung transplants at this facility?
  4. What is the expected recovery time and rehabilitation process after a lung transplant?
  5. What medications will I need to take after a lung transplant and what are the potential side effects?
  6. What lifestyle changes will I need to make after a lung transplant to ensure the best possible outcome?
  7. What are the potential complications or risks associated with a lung transplant surgery?
  8. How often will I need to follow up with my transplant team after the surgery?
  9. What support services are available for transplant patients, such as counseling or support groups?
  10. What are the alternatives to a lung transplant, and how do they compare in terms of effectiveness and long-term outcomes?

Reference

Authors: Kearns SK, Hernandez OO. Journal: AACN Adv Crit Care. 2016 Jul;27(3):293-300. doi: 10.4037/aacnacc2016792. PMID: 27959313