Lenihan Martin, Mullane Darren, Buggy Donal, Flood Georgina, Griffin Michael
Mater Misericordiae University Hospital, School of Medicine, University College, Dublin, Ireland.
Mater Misericordiae University Hospital, School of Medicine, University College, Dublin, Ireland.
J Cardiothorac Vasc Anesth. 2018 Oct;32(5):2372-2380. doi: 10.1053/j.jvca.2017.11.041. Epub 2017 Nov 23.
Cystic fibrosis (CF) is an autosomal recessive disorder affecting approximately 1 in 2,500 live births worldwide, with double this estimated frequency in Ireland. CF is characterized by a genetic defect of the CF transmembrane regulator protein, causing impairment of chloride ion transportation. This has multisystem consequences, particularly in the lungs, where it results in intensely mucoid secretions, which increases susceptibility to infection. Lung transplantation is indicated in CF when there is progressive decline in a patient's functional reserve. In this report, the authors present a 6-year case review of allograft lung transplantations in 41 CF patients from the Irish National Centre for Lung Transplantation from 2010 through 2015. Preoperative risk factors for morbidity and major mortality are discussed. The authors' experience with intraoperative anesthetic challenges and management options are outlined, and postoperative complications are discussed.
囊性纤维化(CF)是一种常染色体隐性疾病,全球每2500例活产婴儿中约有1例受其影响,在爱尔兰估计发病率是这一数字的两倍。CF的特征是囊性纤维化跨膜调节蛋白存在基因缺陷,导致氯离子运输受损。这会产生多系统影响,尤其是在肺部,会导致大量黏液样分泌物,增加感染易感性。当患者的功能储备逐渐下降时,CF患者需要进行肺移植。在本报告中,作者对2010年至2015年期间爱尔兰国家肺移植中心41例CF患者的同种异体肺移植进行了为期6年的病例回顾。讨论了术前发病和主要死亡的危险因素。概述了作者在术中麻醉挑战和管理选择方面的经验,并讨论了术后并发症。