Hi, it's Patrik Hutzel from INTENSIVECAREHOTLINE.COM, where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of "YOUR QUESTIONS ANSWERED" and in last week’s episode I answered another question from our readers and the question last week
was
My 84 year old Dad has been in ICU for three months! He's ventilated with a tracheostomy, the doctors want to let him die and turn off the ventilator! We want to take him home instead, what are our options? (PART 3)
You
can check out the answer to last week's question by clicking on the link here.
In this week’s episode of "YOUR QUESTIONS ANSWERED" I want to answer another question that some of our readers have quite frequently and the question this week is
How long does someone stay in Intensive Care when having a lung transplant?
This is a question we get quite
frequently from our readers, therefore it’s time to answer one of the most common questions around lung transplants and Intensive Care.
The number of organ donations is on the rise worldwide and there are huge campaigns taking place in first world countries to increase the number of organ donors so that people in need of organ donations can benefit and have a second chance at life.
According
to data from the world health organisation WHO 3,400 lung transplants are performed worldwide annually with the number slightly increasing every year. The main restricting factor of growing that number is the limited number of organ donors, hence the big campaigns from many governments and departments of health with a call for more organ donors.
Back to our original question
How long does someone stay in Intensive Care when having a lung transplant?
So from my experience, the best that I have seen in over 15 years Intensive Care nursing in three different countries, where I literally worked with thousands of critically ill Patients and their families is that if all goes well, a lung transplant Patient can leave Intensive Care within 24-48
hours.
Back to our original question and therefore if your critically ill loved one can leave Intensive Care within 24-48 hours after a lung transplant, everything has to go smoothly if that’s the case.
The reality however is that lung transplantation is and will remain a fairly risky procedure for a
long time to come.
People will get better at it the more they practice doing it and the more data people gather, but if you think about it 3,400 lung transplants a year worldwide is not that big of a number, therefore the number of Hospitals and the number of Intensive Care Units worldwide who have exposure to this type of procedure is limited.
Thankfully, I have worked in Intensive Care
Units where I looked after Patients with lung transplants so I have had plenty of exposure and experience with this type of procedure.
Now, if you want to check the type of diseases that may lead to the lungs failing and that may lead to a lung transplant, please check out our general section for lung transplants here.
Lung transplant
Again, a lung transplantation is a fairly risky procedure and therefore length of stay in Intensive Care may vary
from 24-48 hours to many weeks and many months.
Also, critically ill Patients in Intensive Care who had a lung transplant usually have a fairly long-standing pre-medical history often with potential for complicating factors.
In the worst case scenario, a critically ill Patient after a single or double lung transplant- single meaning having one lung transplanted and double meaning having both
lungs transplanted- may stay in Intensive Care for many weeks or many months to come.
If that’s the case, complications such as early rejection of the set of donor lungs or other issues such as infection may arise.
Again, for more information about complications check out our general section for lung transplantation here
Lung transplant
If complications after single or double lung transplantation occur, advanced therapy such as V-V ECMO may be necessary to give the new donor lungs a chance to work in a new body.
If weaning off the ventilator can’t be
happening quickly or if other complications after single or double lung transplantation do occur, advanced therapy such as V-V ECMO may be necessary to give the new donor lungs a chance to work in a new body.
VV- ECMO for example is a very invasive therapy and certainly leads to a prolonged stay in Intensive Care. It also often leads to prolonged mechanical ventilation and often tracheostomy as well.
Related article/video:
Another issue that I have seen in many cases of lung transplantations is
that Patients have been so poorly pre-lung transplantation and they have been de-conditioned and have often been on lots of support including home oxygen that they feel the lung transplantation has not improved their situation because they have been so sick for so long.
I am talking about a psychological factor here that can’t be underestimated.
For example, when looking at clinical signs
after a lung transplant, everything may look fine like breathing, oxygen saturation, heart rate, pain control etc… and yet critically ill Patients who just had a lung transplant are often still thinking that they are limited in their abilities to do stuff and I have seen this leading to a downward spiral.
Therefore, supporting your critically ill loved one from day one after a lung transplant is critical so that they feel encouraged to get up,
get on their way to recovery as quickly as possible!
Again, the psychological support can’t be underestimated.
Furthermore, I have also found that if lung transplant recipients have goals and aspirations for things that they weren’t able to do before they had a new set of donor lungs shortens the stay in Intensive Care too!
I remember
having looked after a guy in his early forties and he was desperate to get back on a pushbike, something he was unable to do before having a new set of donor lungs!
Therefore having goals helps to speed up the recovery process!
Unfortunately I have seen that some Patients who don’t have goals and aspirations have a higher complication rate and also seem to have a longer length of stay in
Intensive Care!
As a rule of thumb, the longer a critically ill Patient stays in Intensive Care and is facing issues such as early rejection of the new set of donor lungs or is facing issues such as an infection, the higher chances are that length of stay is increased.
The longer the stay in Intensive Care after a lung transplant also increases chances to get a tracheostomy to help come off the ventilator.
Now, if issues such as rejection or infection come up and the length of stay is increased in Intensive Care it does increase the chances of prolonged suffering as well
as dying.
The longer a critically ill Patient after a lung transplant stays in Intensive Care with complicating factors such as ECMO, rejection, infection and/or tracheostomy there is a good chance that length of stay can range from many days to many weeks or even many months.
This can often go hand in hand with tracheostomy and prolonged ventilation.
Related articles/videos:
I have also seen a fair number of Patients who have had a lung transplant a while back-ranging from months to years- and then come back to Intensive Care with lung failure often caused by
rejection and then end up being ventilated with a tracheostomy and again they can spend prolonged periods in Intensive Care, ranging from many weeks to many months.
This may lead to mechanical ventilation
dependency and if that’s the case, if you are finding that either yourself or your critically ill loved one is faced with such a challenge that they can’t be weaned off the ventilator and tracheostomy after a lung-transplantation, you may want to consider options such as INTENSIVE CARE AT HOME for long-term ventilated adults& children with tracheostomy.
In some cases a tracheostomy may not be necessary but other forms of ventilator
dependency may apply such as non-invasive forms of ventilation like BIPAP.
Accredited home care services like INTENSIVE CARE AT HOME provide a genuine alternative to a long-term stay in Intensive
Care for chronically ill long-term ventilated adults& children with tracheostomies as well as BIPAP/NIV ventilation.
Chronically ill and long-term ventilated adults& children with tracheostomies have no quality of life and/or quality of end of life in Intensive Care and therefore INTENSIVE CARE AT HOME provides a valuable option to leave a sterile and depressing Intensive Care environment.
On top of that, a prolonged stay in Intensive Care is not only burdensome, it’s also very resource intensive and costly. A bed in Intensive Care costs around $5,000 per bed day and a service like INTENSIVE CARE AT HOME can provide a
similar service at home for around half of the cost.
Check out options
It’s a win-win
situation, with an improved quality of life and/or quality of end of life for Patients and their families, it’s cost effectiveness for Intensive Care Units and it also helps to free up expensive, precious and “in-demand” Intensive Care beds.
Therefore, don’t be discouraged if your loved one is staying in Intensive Care for prolonged periods after A LUNG TRANSPLANT as it may happen.
Get
educated if it does happen, stay positive and keep looking for options.
