Perioperative management of lung volume reduction patients

Over the last 2 to 3 years, surgical lung volume reduction via sternotomy or thoracoscopy has been widely explored as an alternative to improve dyspnea, exercise tolerance, and lung mechanics in patients with severe emphysema. In this article, the authors describe the intra- and postoperative management of patients with severe airflow obstruction who undergo this procedure. Anesthesia techniques, extubation, ventilatory management, and overall medical and surgical care are reviewed. The most common postoperative complications also are reviewed, and management of these complications is discussed.