Perioperative Circulatory Support and Management for Lung Transplantation: A Case-Based Review.
Hong LiangAshley V FritzArcher K MartinPublished in: Seminars in cardiothoracic and vascular anesthesia (2022)
Lung transplantation (LTx) historically was performed with cardiopulmonary bypass (CPB) or Off-pump. Recent data suggest an increased interest in extracorporeal membrane oxygenation (ECMO) as perioperative circulatory support by many lung transplantation centers worldwide. However, there are no established guidelines for anesthetic management for LTx. We present a patient with a history of systemic sclerosis and interstitial lung disease complicated by acute onset of systemic pulmonary hypertension and right heart failure undergoing LTx. We aim to discuss perioperative circulatory support, including ECMO bridge to LTx, and how best to consider the varied intraoperative strategies of CPB vs ECMO vs off-pump during LTx, intraoperative maintenance, and coagulation management.
Keyphrases
- extracorporeal membrane oxygenation
- systemic sclerosis
- interstitial lung disease
- respiratory failure
- acute respiratory distress syndrome
- patients undergoing
- heart failure
- cardiac surgery
- pulmonary hypertension
- rheumatoid arthritis
- mechanical ventilation
- left ventricular
- case report
- drug induced
- machine learning
- electronic health record
- clinical practice
- atrial fibrillation
- hepatitis b virus
- big data
- intensive care unit
- artificial intelligence