HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Donna E. Maziak Janet R. Maurer Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maziak, D. E. Articles by Kesten, S. Search for Related Content PubMed PubMed Citation Articles by Maziak, D. E. Articles by Kesten, S.

Ann Thorac Surg 1996;61:170-173
© 1996 The Society of Thoracic Surgeons

---

Original Articles: General Thoracic

Diaphragmatic Paralysis: A Complication of Lung Transplantation

Departments of Surgery and Medicine, University of Toronto, The Toronto Hospital, Toronto, Ontario, Canada

Accepted for publication August 16, 1995.

Background. Damage to the phrenic nerve, either unilaterally or bilaterally, is a well-documented complication of cardiac operation, but less commonly reported after lung transplantation.

Methods. A retrospective review of 185 single and sequential single lung transplant procedures was performed at The Toronto Hospital. Objective confirmation (fluoroscopy or ultrasound) of diaphragmatic paralysis was found in 6 patients. Paralysis was unilateral in 5 patients (all were left sided) and bilateral in 1 patient.

Results. The average length of ventilation was 8.2 ± 9.2 days with an average intensive care unit stay of 11.2 ± 10.6 days. Mean duration in the hospital was 37.5 ± 11.1 days. The average length of intensive care unit stay and hospitalization were compared with all other sequential single transplantations performed from approximately the time of the first documented case of diaphragmatic paralysis. Intensive care unit stay and hospitalization for the other (no diaphragmatic paralysis) transplant recipients were significantly shorter (5.3 ± 2.7 and 29.1 ± 12.9 days, respectively; p < 0.05). One patient required noninvasive ventilatory assistance via bilevel positive airway pressure in the hospital. One other patient used bilevel positive airway pressure in the hospital and overnight for 6 months after discharge. All patients obtained acceptable lung function and were ambulatory upon discharge from the hospital.

Conclusions. Clinically detectable diaphragmatic paralysis is an infrequent complication of lung transplantation and is associated with longer intensive care unit stay and hospitalization, but is not associated with significant adverse outcomes.

This article has been cited by other articles:

				M. Shihata and J. C. Mullen Bilateral Diaphragmatic Plication in the Setting of Bilateral Sequential Lung Transplantation Ann. Thorac. Surg., March 1, 2007; 83(3): 1201 - 1203. [Abstract] [Full Text] [PDF]

				R. M. Kotloff, V. N. Ahya, and S. W. Crawford Pulmonary Complications of Solid Organ and Hematopoietic Stem Cell Transplantation Am. J. Respir. Crit. Care Med., July 1, 2004; 170(1): 22 - 48. [Abstract] [Full Text] [PDF]

				S. M. Arcasoy and R. M. Kotloff Lung Transplantation N. Engl. J. Med., April 8, 1999; 340(14): 1081 - 1091. [Full Text] [PDF]

				P. S. Myles Aspects of Anesthesia for Lung Transplantation Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1998; 2(2): 140 - 154. [Abstract] [PDF]