A102-16 Transvenous Diaphragmatic Neurostimulation to Facilitate Ventilator Weaning in Post-lung Transplant Patients
Abstract
Prolonged mechanical ventilation (MV) occurs in approximately 14% of post lung transplant patients and is associated with increased mortality. The AeroPace temporary transvenous diaphragmatic neurostimulation (TTDN), a novel FDA-approved device, has been shown to shorten MV duration by an average of 2.8 days (Lungpacer Medical, PA). In the RESCUE3 study, the AeroPace patient were weaned 34% faster by day 30 or 43% faster per protocol. We describe our single-center experience using TTDN in lung transplant recipients requiring prolonged MV and extracorporeal membrane oxygenation (ECMO).
Between June and August 2021, patients with difficulty weaning from MV following lung transplantation at the University of Florida were identified under the Emergency Use Authorization (EUA) program during the COVID-19 pandemic. The AeroPace TTDN subclavian catheter was placed at bedside. Each TTDN session delivered 60 electrical stimulations, administered once or twice daily during volume-controlled or pressure-support ventilation. Therapy was continued until successful liberation from MV or for a maximum of 30 days.
Three patients underwent TTDN therapy. Case 1: A 55-year-old man underwent bilateral orthotopic lung transplantation (BOLT) for drug-induced fibrotic lung disease, complicated by primary graft dysfunction requiring veno-venous (VV) ECMO and six months of MV. After 30 days of TTDN and subsequent automatic tube compensation (ATC) trials, he was successfully liberated from MV. Case…
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