肺移植的最新情况:麻醉方面的考虑
Ashley V Fritz1, Miguel T Teixeira2, Saumil J Patel3
1Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA.
Annals of translational medicine
|November 16, 2023
概括
肺移植 (LTx) 已经取得了显著的进步,全球已有超过7万项手术. 现代术后护理和麻醉策略正在改善肺移植接受者的长期结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 移植手术 移植手术
背景情况:
- 肺移植 (LTx) 从早期的单一专业努力发展成为全球多学科领域.
- 全球已完成超过7万例肺移植手术,治疗末期肺部疾病的进展仍在继续.
- LTx的多学科性质需要在不断发展的患者护理策略中综合考虑麻醉.
研究的目的:
- 审查肺移植 (LTx) 的新兴策略.
- 为了突出捐赠者池扩张,外科手术期间的支持和麻醉技术的进步.
- 讨论这些策略对患者长期结果的影响.
主要方法:
- 关于肺移植 (LTx) 进展的当前文献的审查.
- 讨论包括扩大捐赠池,体外生命支持和心声回声等策略.
- 麻醉技术的分析,旨在减轻初级移植功能障碍.
主要成果:
- 术后护理的显著改进正在增强21世纪的LTx实践.
- 新兴的战略正在解决LTx的挑战,从而改善患者管理.
- 麻醉方面的考虑对于整合新的手术,医疗和系统技术至关重要.
结论:
- 在LTx的进展,包括捐赠者池的扩大和改进的外科手术后支持,正在改善患者的治疗结果.
- 麻醉技术在缓解初级移植功能障碍和改善长期结果方面发挥着至关重要的作用.
- 麻醉师融入多学科的LTx团队对于最佳的患者护理至关重要.
相关概念视频
Inhalational Anesthetics: Overview
305
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
305
General Anesthesia: Overview
223
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
223
Parenteral Anesthetics: Overview
131
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
131
Local Anesthetics: Common Agents and Their Applications
454
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
454
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.1K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.1K
Local Anesthetics: Clinical Application as Spinal Anesthesia
641
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
641


