RESPIRATORY
LUNG TRANSPLANT
PromptFebrile 28 yo 6/12 post lung transplant
ResponseBilateral areas of consolidation RML, RLL and LLL
Multiple clips bilaterally consistent with double lung transplant
CTR within normal limits
No ptx/effusion, no free gas under diaphragm
Multiple clips bilaterally consistent with double lung transplant
CTR within normal limits
No ptx/effusion, no free gas under diaphragm
PromptDifferentials for toxic lung transplant
ResponseInfection - bacterial/viral/fungal
Acute rejection
CCF
PE
ARDS secondary to sepsis/immunosuppression
Bronchiolitis obliterans
Acute rejection
CCF
PE
ARDS secondary to sepsis/immunosuppression
Bronchiolitis obliterans
PromptManagement
ResponseO2 therapy to maintain PO2>60
May need respiratory support with NIV or intubation if failing to oxygenate on NRBM alone
Broad spectrum antibiotics with antifungal and antiviral cover - Taz + fluconazole + aciclovir
Steroids under guidance of transplant team
Early referral to transplant specialist
Caution with IV fluid resuscitation
Check levels of immunosuppressant drugs
May need respiratory support with NIV or intubation if failing to oxygenate on NRBM alone
Broad spectrum antibiotics with antifungal and antiviral cover - Taz + fluconazole + aciclovir
Steroids under guidance of transplant team
Early referral to transplant specialist
Caution with IV fluid resuscitation
Check levels of immunosuppressant drugs