Anaes SAQs · Thoracic anaesthesia
Anaesthesia for lung transplantation
Final-examination SAQ for lung-transplant-anaesthesia.
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ANZCAFRCAEDAICABAFCAI
Prompt
Outline the anaesthetic management of bilateral sequential lung transplantation for idiopathic pulmonary fibrosis with moderate pulmonary hypertension.
Model answer
Risk (3). Stiff lungs, PHT/RV risk at induction and clamp; prepare ECMO/CPB.[2]
Induction/monitoring (4). Invasive lines, TOE/PAC as used, careful induction, iNO/vasoactive support, airway plan.[1]
Intraop phases (4). OLV, PA clamp trial, implant, gentle reperfusion, protective ventilation, fluid restraint for graft.[1]
Crises (2). RV failure → medical then mechanical support; PGD pathway.[1][2]
ICU (2). Protective vent, immunosuppression, PGD surveillance.[1]
References3ShowHide
- [1]Marczin N, de Waal EEC, Hopkins PMA, et al. International consensus recommendations for anesthetic and intensive care management of lung transplantation. An EACTAIC, SCA, ISHLT, ESOT, ESTS, and AST approved document. Journal of Heart and Lung Transplantation, 2021.PMID 34732281
- [2]Kim HJ, Shin SW, et al. A Review of Anesthesia for Lung Transplantation. Journal of Chest Surgery, 2022.PMID 35924536
- [3]Mazer CD, Whitlock RP, Fergusson DA, et al. Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery. New England Journal of Medicine, 2017.PMID 29130845