Aspects of anesthesia for lung transplantation

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Anesthesia for lung transplantation is both a demanding and rewarding experience. Success requires teamwork, experience, knowledge of cardiorespiratory pathophysiology and its anesthetic implications, appropriate use of noninvasive and invasive monitoring, and the ability to respond quickly and effectively to life-threatening perioperative events. Specific issues include management of a patient with end-stage lung and heart disease, lung isolation and one-lung ventilation, perioperative respiratory failure, pulmonary hypertension, and acute right ventricular failure. Recent advances include greater understanding of dynamic hyperinflation ('gas- trapping') during mechanical ventilation, perioperative use of inhaled nitric oxide and treatment of acute right ventricular failure. Successful anesthetic management leads to greater hemodynamic stability, improvement in gas exchange and a reduction in need for cardiopulmonary bypass, all of which should lead to improved patient outcome.

Original languageEnglish
Pages (from-to)140-154
Number of pages15
JournalSeminars in Cardiothoracic and Vascular Anesthesia
Issue number2
Publication statusPublished - 1998

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