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[Anesthesia in unilateral pulmonary transplantation]
M Moutafis1, L Raffin, P Bonnette
1Service d'Anesthésie, Centre Médico-Chirurgical, Suresnes.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1991
Summary
Single lung transplantation effectively treated severe lung diseases like lymphangiomyomatosis and emphysema. Surgeons managed intraoperative challenges including hypoxia and hypercapnia during the procedure.
Area of Science:
- Cardiothoracic Surgery
- Pulmonary Medicine
- Anesthesiology
Background:
- Single lung transplantation is a complex procedure for end-stage lung diseases.
- Patients with lymphangiomyomatosis, emphysema, and idiopathic pulmonary fibrosis underwent transplantation.
- Preoperative immunosuppressive treatment was administered.
Purpose of the Study:
- To describe the surgical technique and anesthetic management for single lung transplantation.
- To identify and discuss intraoperative complications encountered during the procedure.
Main Methods:
- Surgical steps included laparotomy for omentopexy, pneumonectomy, and graft implantation via thoracotomy.
- Anesthesia involved alfentanil, midazolam, and vecuronium, with ventilation using an oxygen-air mixture.
- Monitoring included expired CO2 and pulmonary artery oxygen saturation; cardiopulmonary bypass was not required.
Main Results:
- Major complications included hypoxia, hypercapnia, and pulmonary arterial hypertension.
- Hypoxia occurred during one-lung ventilation and after graft reperfusion.
- Specific challenges in emphysematous patients involved hypotension and thoracic asymmetry.
Conclusions:
- Single lung transplantation can be performed with careful anesthetic management and monitoring.
- Proactive management of hypoxia, hypercapnia, and hemodynamic instability is crucial.
- Addressing specific patient conditions like emphysema is vital for successful outcomes.