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一项关于中国肺移植麻醉管理现状的全国性调查。

A nationwide survey on current practices in anesthesia management for lung transplantation in China.

作者信息

Yang Jiajia, Wu Xiaowen, Miao Shuai, Chen Jingyu, Tian Tian, Chen Wankun, Wang Guilong, Zhang Xin, Zhou Yan

机构信息

Department of Anesthesiology, Wuxi People's Hospital, Wuxi Medical Center, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, #299 Qingyang Road, Wuxi, 214023, Jiangsu, China.

Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, 200000, China.

出版信息

Sci Rep. 2025 Jul 7;15(1):24314. doi: 10.1038/s41598-025-10389-0.

Abstract

Lung transplantation is a critical treatment for patients with end-stage lung disease, demanding precise intraoperative anesthetic management. This study aims to assess the current state of anesthesia management in lung transplant surgeries across China. An online survey was conducted in June 2024 among anesthesiology trainees from Wuxi People's Hospital, covering those trained between 2015 and 2024. The survey, comprising 34 questions, was distributed to participants who were stratified into intermediate and senior groups based on their clinical experience and professional designation. Out of 85 eligible anesthesiologists, 70 (82.4%) from 52 hospitals across 22 provinces in China responded. The most commonly used induction agent was etomidate (95.7%), followed by propofol (58.6%). Sufentanil was universally employed for intraoperative analgesia (100%), alongside remifentanil (71.4%) and oxycodone (24.3%). Extracorporeal membrane oxygenation (ECMO) was the predominant mechanical support used (98.6%), while pressure-controlled ventilation was the preferred mode (95.7%). Significant variations were observed in anesthetic practices, including fluid management, coagulation monitoring, and the use of transesophageal echocardiography (TEE). This study underscores the critical role of anesthesiologists in lung transplantation and highlights the need for standardization and enhanced education to improve patient outcomes. Future research should focus on refining anesthetic protocols and integrating advanced monitoring tools to elevate the safety and efficacy of lung transplants in China.

摘要

肺移植是终末期肺病患者的关键治疗手段,需要精确的术中麻醉管理。本研究旨在评估中国肺移植手术中麻醉管理的现状。2024年6月对无锡市人民医院的麻醉科住院医师进行了一项在线调查,涵盖2015年至2024年期间接受培训的人员。该调查包含34个问题,分发给根据临床经验和专业职称分为中级和高级组的参与者。在中国22个省份52家医院的85名合格麻醉医生中,有70名(82.4%)做出了回应。最常用的诱导剂是依托咪酯(95.7%),其次是丙泊酚(58.6%)。舒芬太尼普遍用于术中镇痛(100%),同时使用瑞芬太尼(71.4%)和羟考酮(24.3%)。体外膜肺氧合(ECMO)是主要使用的机械支持手段(98.6%),而压力控制通气是首选模式(95.7%)。在麻醉操作方面观察到显著差异,包括液体管理、凝血监测和经食管超声心动图(TEE)的使用。本研究强调了麻醉医生在肺移植中的关键作用,并突出了标准化和加强教育以改善患者预后的必要性。未来的研究应侧重于完善麻醉方案并整合先进监测工具,以提高中国肺移植的安全性和有效性。

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本文引用的文献

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