[Anesthetic management in unilateral lung transplantation]

To describe and evaluate anesthetic treatment during single lung transplantation (SLT).

This is a retrospective study of patients undergoing SLT during one year of our program's operation. We describe the surgical technique and method of anesthesia, which consisted in combined general and epidural anesthesia. Systemic and pulmonary arterial pressures, heart rate, arterial and mixed venous oxygen saturation were monitored throughout the procedure, along with inspired and expired gases and airway pressure. The following parameters were recorded for the various phases of surgery: cardiac index (CI), right ventricular ejection fraction (REF) and systemic and pulmonary vascular resistances, arterial and mixed venous blood gas readings.

Eight SLT were performed during the study period and the survival rate was 100%. PaCO2 and pulmonary artery pressure increased at the start of ventilation of a single lung. These values increased again when the pulmonary artery was clamped. During this period, however, CI and REF held steady and venous oxygen saturation decreased only slightly. Cardiopulmonary bypass was therefore never used. The variables returned to normal upon revascularization of the new lung.

In spite of the small series studied, the excellent results obtained lead us to conclude that our method is appropriate and that SLT is a valid therapeutic alternative for our patients.