MI-Edon study: the role of respiratory physiotherapy as a tool for the optimization of the lung donor.

Background: Mechanical Insufflation-exsufflation (MIE) is a non-invasive device that simulates patient cough favoring the elimination of secretions. Although it is frequently used in critically ill patients, there is no evidence of its role on the optimization of lung organ donors. We intend to assess whether the use of MI-E in all eligible consented donors (ED) is safe and improves oxygenation parameters.

Methods: Preliminary safety analysis of a prospective multicenter study conducted in 4 spanish centers. After completing a national maintenance protocol oriented towards pulmonary optimization (OTP) all patients undergoing 4 MI-E cycles were analysed. Blood gas monitoring (Pa/FiO2) (FiO2 1/PEEP 5) was performed. Complications derived from the technique were recorded.

Results: A total of 10 ED were included. Five donors were initially considered eligible for lung donations (PaFi>300, ELD) and 5 were not (PaFI<300, NELD).ELD maintained PaFi>400 after the MI-E. Four out of 5 NELD increased a 25.4% Pa/Fi and maintained over time. (Table 1). No MIE-related complications were reported. 

Conclusions: MI-E seems to be a safe and useful technique to increase the lung donor pool.