LESSONS FROM LUNG TRANSPLANTATION FOR EVERYDAY THROACIC ANESTHESIA - 03/09/11
Résumé |
Patients with end-stage lung disease are at significant risk during thoracic surgery, and continue to be at increased risk throughout the postoperative period. Problems may occur with mechanical ventilation, particularly during one-lung ventilation, and at the end of surgery when patients are expected to regain spontaneous ventilation and maintain acceptable gas exchange. These patients have marked impairment of ventilatory function or gas exchange, and need optimal intraoperative management geared toward early recovery and tracheal extubation. Experience in the management of patients undergoing lung transplantation,26 and more recently, lung volume reduction surgery,7 has highlighted the following issues:
• | Dynamic hyperinflation during mechanical ventilation |
• | Acceptance of permissive hypercapnia |
• | Methods to reduce the incidence of hypoxia during one-lung ventilation |
• | Optimizing recovery from anesthesia |
• | Optimizing postoperative analgesia |
Plan
| Address reprint requests to Paul S. Myles, MD, MBBS, MPH, Department of Anaesthesia and Pain Management, Alfred Hospital, PO Box 315, Prahran, Vic. 3181, Australia, e-mail: p.myles@alfred.org.au |
Vol 19 - N° 3
P. 581-590 - septembre 2001 Retour au numéro
Article précédent
- ANESTHESIA FOR PATIENTS WITH A MEDIASTINAL MASS
- Sanjeet Narang, Brian H. Harte, Simon C. Body
- ANESTHESIA CONSIDERATIONS FOR LUNG VOLUME REDUCTION SURGERY
- Edda M. Tschernko
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