肺移植围手术期的液体管理具有挑战性。
Perioperative fluid management for lung transplantation is challenging.
作者信息
Duan Qirui, Zhang Yajun, Yang Dong
机构信息
Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China.
China-Japan Friendship Hospital, Beijing, 100020, China.
出版信息
Heliyon. 2023 Mar 21;9(4):e14704. doi: 10.1016/j.heliyon.2023.e14704. eCollection 2023 Apr.
Lung transplantation is the definitive end-stage treatment for many lung diseases, and postoperative pulmonary oedema severely affects survival after lung transplantation. Optimizing perioperative fluid management can reduce the incidence of postoperative pulmonary oedema and improve the prognosis of lung transplant patients by removing the influence of patient, donor's lung and ECMO factors. Therefore, this article reviews seven aspects of lung transplant patients' pathophysiological characteristics, physiological characteristics of fluids, the influence of the donor lung on pulmonary oedema as well as current fluid rehydration concepts, advantages or disadvantages of intraoperative monitoring tools or types of fluids on postoperative pulmonary oedema, while showing the existing challenges in section 7. The aim is to show the specificity of perioperative fluid management in lung transplant patients and to provide new ideas for individualised fluid management in lung transplantation.
肺移植是许多肺部疾病的最终末期治疗方法，术后肺水肿严重影响肺移植后的生存率。优化围手术期液体管理可以通过消除患者、供体肺和体外膜肺氧合（ECMO）因素的影响，降低术后肺水肿的发生率，改善肺移植患者的预后。因此，本文综述了肺移植患者病理生理特征、液体生理特征、供体肺对肺水肿的影响以及当前的液体补液概念、术中监测工具或液体类型对术后肺水肿的优缺点等七个方面，同时在第7节展示了现存的挑战。目的是展现肺移植患者围手术期液体管理的特殊性，并为肺移植个体化液体管理提供新思路。
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