Kumar Anand, Dhir Udgeath, Jain Vishal, Yadav Surendra, Purohit Ankit
Department of Cardiac Anaesthesia, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
Department of CTVS, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
Ann Card Anaesth. 2019 Jan-Mar;22(1):86-88. doi: 10.4103/aca.ACA_37_18.
Pulmonary complications are common in cardiac surgical patients. Limited respiratory reserves along with the pain associated with sternotomy add to the morbidity. Patients undergoing cardiac surgery who have had a pneumonectomy done before can be even more challenging to manage perioperatively due to a single-functioning lung. We present a case of a postpneumonectomy patient who underwent off-pump coronary artery bypass grafting. Perioperative optimization of lung function tests was stressed upon including the chest physiotherapy and early mobilization. Preoperative thoracic epidural catheter was inserted for postoperative pain and other proven benefits of thoracic epidural in coronary artery disease patients. We could conclude from our experience that proper optimization of lung function tests and meticulous pain management along with fast-tracking are keys to the management of such patients.
肺部并发症在心脏外科手术患者中很常见。有限的呼吸储备以及与胸骨切开术相关的疼痛增加了发病率。由于单肺功能，之前接受过肺切除术的心脏手术患者在围手术期的管理可能更具挑战性。我们报告一例接受非体外循环冠状动脉旁路移植术的肺切除术后患者。强调围手术期肺功能测试的优化，包括胸部物理治疗和早期活动。术前插入胸段硬膜外导管用于术后镇痛以及胸段硬膜外对冠心病患者的其他已证实的益处。我们可以从我们的经验中得出结论，适当优化肺功能测试、精心的疼痛管理以及快速康复是这类患者管理的关键。
