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

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.