Baez Bernard, Castillo Maria
Department of Anesthesiology, Good Samaritan Hospital, Suffren, New York, USA.
Semin Cardiothorac Vasc Anesth. 2008 Jun;12(2):122-7. doi: 10.1177/1089253208319871.
Lung transplantation is the definitive treatment for end-stage lung disease. The number of lung transplantations performed is limited by the number of donors available and is far outnumbered by the potential recipients on the waiting list. Advances in surgical methods, organ preservation, and immunosuppression have decreased the morbidity and mortality associated with this procedure during the last few decades. Specific anesthetic concerns are associated with lung transplantation, including careful preoperative assessment of pulmonary and cardiac function, adequate venous access and monitors, and ventilation techniques, such as 1-lung ventilation and lung-protective strategies to decrease the risks of reperfusion injury, barotrauma, and re-expansion pulmonary edema. Intraoperative transesophageal echocardiography, cardiopulmonary bypass, and inhaled nitric oxide can also be important tools for the anesthesiologist to optimize patient care during this challenging procedure.
肺移植是终末期肺病的确定性治疗方法。肺移植手术的数量受到可用供体数量的限制，且远远少于等待名单上的潜在受者数量。在过去几十年中，手术方法、器官保存和免疫抑制方面的进展降低了与该手术相关的发病率和死亡率。肺移植存在一些特定的麻醉关注点，包括术前对肺和心脏功能进行仔细评估、建立充足的静脉通路和监测手段，以及采用通气技术，如单肺通气和肺保护策略，以降低再灌注损伤、气压伤和复张性肺水肿的风险。术中经食管超声心动图、体外循环和吸入一氧化氮也是麻醉医生在这一具有挑战性的手术过程中优化患者护理的重要工具。
