Oxygenation and Ventilation Strategies for Patients Undergoing Lung Resection Surgery After Prior Lobectomy or Pneumonectomy

Durkin, Chris; Lohser, Jens

doi:10.1007/s40140-016-0153-x

Cited by 3 publications

(2 citation statements)

References 62 publications

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“…Oxygenation challenge and critical hypercapnia are likely to be more prevalent in repeated surgery due to the lack of functional parenchyma, less vascular territory, and altered lung mechanics after prior contralateral lobectomy [2,14]. The loss of lung function in patients with a prior lobe resection is approximately 24% [15].…”

Section: Discussionmentioning

confidence: 99%

“…However, in patients with prior contralateral thoracic surgery, hypoxemia may occur due to the presence of relatively fewer functional alveoli in the residual lung at the dependent side during one-lung ventilation. Moreover, elevated shunt fraction and reduced functional lung parenchyma complicate one-lung ventilation during secondary contralateral lobectomy [2]. Therefore, an appropriate anesthesia method should be selected with meticulous care for a secondary contralateral thoracic surgery due to inadequate cardiopulmonary reserve and unfavorable pathophysiological changes [3].…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of Spontaneous Ventilation in Secondary Contralateral Thoracic Surgery

et al. 2019

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BackgroundA secondary contralateral thoracic surgery is a challenging procedure and is rarely indicated. We retrospectively compared the perioperative values to find out whether video-assisted thoracoscopic surgery under spontaneous ventilation is feasible for this surgery.Material/MethodsPatients were retrospectively collected from January 1, 2015 to December 30, 2018 who underwent secondary contralateral video-assisted thoracoscopic surgeries with mechanical ventilation (MV-VATS group) or spontaneous ventilation (SV-VATS group). A propensity score-matching analysis was used to counterbalance the discrepancies. The primary outcome measures were the values of respiratory mechanics and hemodynamics, and the secondary outcome measures were postoperative recovery and complications.ResultsIn the SV-VATS group, the operation and anesthesia times were shorter (P=0.008 and P=0.020, respectively). The peak respiratory pressure value was lower (P<0.001), and there was less use of analgesic drugs during the operation (P<0.001). The vital signs and oxygenation were stable during the operation and in post-anesthesia care unit. The extubation time of laryngeal mask airway, chest-tube duration, and postoperative hospital stay were shorter in the SV-VATS group (P=0.015, P=0.000, P=0.003, respectively), but the duration of intensive care unit stay, the postoperative clinical complications, and chest radiography results were not significantly different between the 2 groups (P>0.05). In the SV-VATS group, postoperative leukocyte count (P<0.001) and neutrophil ratio (P=0.001) were lower and the postoperative value of PaCO2 was slightly higher (P=0.026).ConclusionsVATS under spontaneous ventilation might be an alternative approach for patients who undergo a secondary contralateral thoracic surgery with intraoperative stable vital signs, and does not increase postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility of Spontaneous Ventilation in Secondary Contralateral Thoracic Surgery

et al. 2019

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Clinical Management of One-Lung Ventilation

Schisler¹,

Lohser²

2019

Principles and Practice of Anesthesia for Thoracic Surgery

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Extracorporeal Membrane Oxygenation Use in Thoracic Surgery

2021

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This narrative review is focused on the application of extracorporeal membrane oxygenation (ECMO) in thoracic surgery, exclusive of lung transplantation. Although the use of ECMO in this indication is still rare, it allows surgery to be performed in patients where conventional ventilation is not feasible—especially in single lung patients, sleeve lobectomy or pneumonectomy and tracheal or carinal reconstructions. Comparisons with other techniques, various ECMO configurations, the management of anticoagulation, anesthesia, hypoxemia during surgery and the use of ECMO in case of postoperative respiratory failure are reviewed and supported by two cases of perioperative ECMO use, and an overview of published case series.

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Oxygenation and Ventilation Strategies for Patients Undergoing Lung Resection Surgery After Prior Lobectomy or Pneumonectomy

Cited by 3 publications

References 62 publications

Feasibility of Spontaneous Ventilation in Secondary Contralateral Thoracic Surgery

Feasibility of Spontaneous Ventilation in Secondary Contralateral Thoracic Surgery

Clinical Management of One-Lung Ventilation

Extracorporeal Membrane Oxygenation Use in Thoracic Surgery

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