Selzer Angela Roberts, Murrell Matthew, Shostak Eugene
aDepartment of Anesthesiology bDepartment of Thoracic Surgery, Weill Cornell Medical College, New York City, New York, USA.
Curr Opin Anaesthesiol. 2017 Feb;30(1):17-22. doi: 10.1097/ACO.0000000000000414.
As the field of interventional pulmonology continues to expand and develop at a rapid pace, anesthesiologists are increasingly called upon to provide well tolerated anesthetic care during these procedures. These patients may not be candidates for surgical treatment and often have multiple comorbidities. It is important for anesthesiologists to familiarize themselves with these procedures and their associated risks and complications.
The scope of the interventional pulmonologist's practice is varied and includes both diagnostic and therapeutic procedures. Bronchial thermoplasty is now offered as endoscopic treatment of severe asthma. Endobronchial lung volume reduction procedures are currently undergoing clinical trials and may become more commonplace. Interventional pulmonologists are performing medical thoracoscopy for the treatment and diagnosis of pleural disorders. Interventional radiologists are performing complex pulmonary procedures, often requiring anesthesia.
The review summarizes the procedures now commonly performed by interventional pulmonologists and interventional radiologists. It discusses the anesthetic considerations for and common complications of these procedures to prepare anesthesiologists to safely care for these patients. Investigational techniques are also described.
随着介入肺病学领域持续快速扩展和发展,麻醉医生越来越多地被要求在这些操作过程中提供耐受性良好的麻醉护理。这些患者可能不适合手术治疗,且往往有多种合并症。麻醉医生熟悉这些操作及其相关风险和并发症很重要。
介入肺病医生的业务范围广泛,包括诊断和治疗操作。支气管热成形术现作为重度哮喘的内镜治疗方法。支气管内肺减容术目前正在进行临床试验,可能会更普遍。介入肺病医生正在开展医疗性胸腔镜检查以治疗和诊断胸膜疾病。介入放射科医生正在进行复杂的肺部操作,通常需要麻醉。
本综述总结了介入肺病医生和介入放射科医生目前常用的操作。讨论了这些操作的麻醉注意事项和常见并发症,以使麻醉医生能安全地护理这些患者。还描述了研究性技术。