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一名重度肺动脉高压患者肾移植的麻醉管理

Anaesthetic management of a patient with severe pulmonary arterial hypertension for renal transplantation.

作者信息

Swamy Mn Chidananda, Mukherjee Aninditha, Rao Latha L, Pandith Sushmitha

机构信息

Department of Anaesthesiology, SAKRA World Hospitals, Bengaluru, Karnataka, India.

Department of Anaesthesiology, BGS Global Hospitals, Bengaluru, Karnataka, India.

出版信息

Indian J Anaesth. 2017 Feb;61(2):167-169. doi: 10.4103/0019-5049.199854.

DOI:10.4103/0019-5049.199854
PMID:28250487
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5330075/
Abstract

We describe a patient with severe pulmonary arterial hypertension scheduled to undergo live-related renal transplantation. We emphasise on meticulous anaesthetic management and early renal transplantation to prevent the progression of disease which would become refractory to treatment, leading to right ventricular failure. Regional (continuous epidural) anaesthesia has been used as technique of choice, where the selective advantages of this technique have been put to good use.

摘要

我们描述了一位计划接受亲属活体肾移植的重度肺动脉高压患者。我们强调要进行细致的麻醉管理并尽早进行肾移植，以防止疾病进展至治疗难治阶段，进而导致右心室衰竭。区域（连续硬膜外）麻醉已被用作首选技术，该技术的选择性优势得到了充分利用。

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本文引用的文献

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Do echocardiographic parameters predict mortality in patients with end-stage renal disease?超声心动图参数能否预测终末期肾病患者的死亡率？
Transplantation. 2013 May 27;95(10):1225-32. doi: 10.1097/TP.0b013e31828dbbbe.
2
Pulmonary hypertension among patients on dialysis and kidney transplant recipients.透析患者和肾移植受者中的肺动脉高压。
Ren Fail. 2013;35(4):560-5. doi: 10.3109/0886022X.2013.766567. Epub 2013 Feb 25.
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A prospective echocardiographic evaluation of pulmonary hypertension in chronic hemodialysis patients in the United States: prevalence and clinical significance.美国慢性血液透析患者肺动脉高压的前瞻性超声心动图评估：患病率和临床意义。
Int J Gen Med. 2010 Oct 5;3:279-86. doi: 10.2147/IJGM.S12946.
4
Non-invasive detection of pulmonary hypertension prior to renal transplantation is a predictor of increased risk for early graft dysfunction.在肾移植前对肺动脉高压进行非侵入性检测是早期移植物功能障碍风险增加的预测指标。
Nephrol Dial Transplant. 2010 Sep;25(9):3090-6. doi: 10.1093/ndt/gfq141. Epub 2010 Mar 17.
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Pulmonary hypertension in patients with end-stage renal disease undergoing renal transplantation.接受肾移植的终末期肾病患者的肺动脉高压
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Effects of the arteriovenous fistula on pulmonary artery pressure and cardiac output in patients with chronic renal failure.动静脉瘘对慢性肾衰竭患者肺动脉压和心输出量的影响。
J Vasc Access. 2009 Jul-Sep;10(3):160-6. doi: 10.1177/112972980901000305.
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Pulmonary hypertension is an independent predictor of mortality in hemodialysis patients.肺动脉高压是血液透析患者死亡率的独立预测因素。
Kidney Int. 2009 May;75(9):969-75. doi: 10.1038/ki.2009.10. Epub 2009 Feb 11.
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Perioperative management including new pharmacological vistas for patients with pulmonary hypertension for noncardiac surgery.围手术期管理，包括非心脏手术患者肺动脉高压的新药理学前景。
Curr Opin Anaesthesiol. 2008 Aug;21(4):467-72. doi: 10.1097/ACO.0b013e3283007eb4.
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Management of pulmonary hypertension in the operating room.手术室中肺动脉高压的管理。
Semin Cardiothorac Vasc Anesth. 2007 Jun;11(2):119-36. doi: 10.1177/1089253207301733.
10
Pulmonary hypertension in patients with chronic renal failure.慢性肾衰竭患者的肺动脉高压
Respiration. 2007;74(5):503-10. doi: 10.1159/000102953. Epub 2007 May 15.