Open AccessAcute ischemic optic neuropathy with extended prone position ventilation in a lung transplant recipient
Author(s) -
Tanmay S. Panchabhai,
Debabrata Bandyopadhyay,
Aanchal Kapoor,
Olufemi Akindipe,
Charles Lane,
Sudhir Krishnan
Publication year - 2016
Publication title -
international journal of critical illness and injury science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.274
H-Index - 12
eISSN - 2231-5004
pISSN - 2229-5151
DOI - 10.4103/2229-5151.177367
Subject(s) - medicine , ards , prone position , hypoxemia , mechanical ventilation , lung , anesthesia , diffuse alveolar damage , optic neuropathy , lung transplantation , ventilation (architecture) , optic nerve , acute respiratory distress , ophthalmology , mechanical engineering , engineering
Prone position ventilation (PPV) improves mortality in severe acute respiratory distress syndrome (ARDS), but outcomes following its use in lung transplant recipients are not known. We report the case of a 42-year-old Caucasian man who presented with severe ARDS from Bordetella pertussis, 5 years after bilateral sequential lung transplant for cystic fibrosis. He was managed with PPV for 22 days and had a prolonged ICU stay complicated by hypoxic ischemic optic neuropathy leading to blindness. Since his discharge from the ICU 6 months ago, his FEV1 has recovered to 47% predicted compared to his pre-ICU peak FEV1 of 85% predicted, suggesting recovery of lung function. This is the first report of optic nerve damage and vision loss in patients undergoing PPV. Our report also suggests that, in appropriately selected lung transplant recipients, severe hypoxemia could potentially be managed with prone ventilation.