Providing Anesthesia For Lung Transplantation - 1538 Words

Providing anesthesia for lung transplantation (LT) is considered by many to be a major feat in cardiothoracic anesthesia. Some say it involves the most complex manipulation of cardiothoracic physiology, especially when cardiopulmonary bypass (CPB) is not used. There are many indications for end-stage pulmonary disease, from obstructive lung disease to pulmonary vascular disease. Traditionally, ventilation strategies for this population included tidal volumes of 8-12ml/kg to prevent atelectasis and zero PEEP to prevent a shunt of blood flow (Slinger, 2012). This strategy proved to cause harm during the periorperative period. Research now indicates that a reduction in tidal volume with added PEEP not only decreases atelectasis, but it also reduces pulmonary inflammatory response (Coppola, Froio, Chuimello 2014). These patients already have a decreased respiratory reserve, therefore inducing an inflammatory mediated response with ventilation settings can be detrimental and should be av oided at all costs by the nurse anesthetist. It is imperative for the nurse anesthetist understand the necessity of lung protective ventilation strategies in LT. Patient Assessment Lung transplantation surgery is often unpredictable and emergent. Therefore, the preoperative workup of transplant recipients must be thoroughly performed in advance with appropriate updating of clinical data and investigations whilst on the waiting list. If the patient has been on the waiting list for an extendedShow MoreRelatedProtective Ventilation And Lung Transplantation Surgery1602 Words   |  7 PagesVentilation in Lung Transplantation Surgery Providing anesthesia for lung transplantation (LT) is considered by many to be a major feat in cardiothoracic anesthesia. Some say it involves the most complex manipulation of cardiothoracic physiology, especially when cardiopulmonary bypass (CPB) is not used. Indications for LT include 4 primary diagnostic groupings of end-stage pulmonary disease: (1) obstructive lung disease (chronic obstructive pulmonary disease (COPD); (2) restrictive lung disease (idiopathic