Erkılınç Atakan, Karaca Baysal Pınar, Gürcü Mustafa Emre
Department of Anesthesiology and Reanimation, Kartal Koşuyolu High Specialization Education and Research Hospital, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2021 Apr 26;29(2):191-200. doi: 10.5606/tgkdc.dergisi.2021.9490. eCollection 2021 Apr.
In this study, we aimed to discuss our anesthesia management strategies, experiences, and outcomes in patients undergoing lung transplantation.
Between December 2016 and December 2018, a total of 53 patients (43 males, 10 females; mean age: 46.1±13 years; range, 14 to 64 years) undergoing lung transplantation in our center were included. The anesthesia technique, patients" characteristics, and perioperative clinical and follow-up data were recorded. The stage of lung disease was assessed using the New York Heart Association functional classification.
Two patients underwent single lung transplantation, while 51 patients underwent double lung transplantation. Idiopathic pulmonary fibrosis was the most common indication in 41.5% of the patients. All patients had end-stage lung disease (Class IV) and 79% were oxygen-dependent. The extracorporeal membrane oxygenation support was given to 32 patients.
The anesthetic management of lung transplantation is challenging, either due to the deterioration of the recipient"s physical performance and the complexity of the surgical techniques used. In general, a kind of mechanical support may be needed and extracorporeal membrane oxygenation is the first choice in the majority of patients. A close communication should be maintained between the surgeons, perfusion technicians, and anesthesiologists to ensure an optimal multidisciplinary approach and to achieve successful outcomes.
在本研究中,我们旨在探讨肺移植患者的麻醉管理策略、经验及结果。
纳入2016年12月至2018年12月期间在本中心接受肺移植的53例患者(43例男性,10例女性;平均年龄:46.1±13岁;范围14至64岁)。记录麻醉技术、患者特征以及围手术期临床和随访数据。采用纽约心脏协会功能分级评估肺部疾病阶段。
2例患者接受单肺移植,51例患者接受双肺移植。特发性肺纤维化是41.5%患者最常见的适应证。所有患者均患有终末期肺部疾病(IV级),79%患者依赖吸氧。32例患者接受了体外膜肺氧合支持。
由于受者身体状况恶化以及所采用手术技术的复杂性,肺移植的麻醉管理具有挑战性。一般来说,可能需要某种机械支持,体外膜肺氧合是大多数患者的首选。外科医生、灌注技师和麻醉医生之间应保持密切沟通,以确保采取最佳的多学科方法并取得成功结果。