Pulmonary Perfusion Using Intrabronchial Capnography in Pulmonary Artery Stenosis

Nishine, Hiroki; Muraoka, Hiromi; Inoue, Tatsuya; Miyazawa, Teruomi; Mineshita, Masamichi

doi:10.1159/000487712

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…This condition, combined with the narrowing of the trachea compressed by LPA, resulted in impaired CO2 clearance. 9 During this period, we increased alveolar ventilation by increasing tidal volume and respiratory rate to reduce CO2. When the LPA was successfully reimplanted, hemodynamic and end-tidal CO2 returned to normal.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic challenges during repairing left pulmonary artery sling without cardiopulmonary bypass: a case report

Arifin,

Perdana

2023

Anaesth. pain intensive care

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Left pulmonary artery sling (LPAS) is a rare vascular anomaly. The general surgical technique to correct it is through median sternotomy under cardiopulmonary bypass (CPB). In this case, we discuss the anesthetic management of left pulmonary artery (LPA) reimplantation without CPB to improve the understanding and provide an overview for practitioners in managing patients with this rare vascular anomaly. Patient was a 10 months old baby, with main complaints of shortness of breath since he was 4 months old, and diagnosed with LPAS from cardiac multi-slice CT scan (MSCT) examination. Intraoperatively, when the LPA was clamped, the blood pressure decreased due to decreased preload, and the end-tidal CO2 increased to 70 mmHg due to increased dead space, which was successfully managed. Postoperatively, the patient suffered from ventilator acquired pneumonia (VAP). Evaluating and assessing the potential complications that can occur during the perioperative period will help prepare for management and improve the success of anesthetic management. Abbreviations: CPB- Cardiopulmonary Bypass; ETT- Endotracheal Tube; LPA- Left Pulmonary Artery; LPAS- Left Pulmonary Artery Sling; MSCT- Multi-Slice CT Scan; RPA- Right Pulmonary Artery; VAP- Ventilator Acquired Pneumonia Key words: Left Pulmonary Artery; Anesthesia Management; Pulmonary Sling; Cardiopulmonary Bypass Citation: Arifin A, Perdana A. Anesthetic challenges during repairing left pulmonary artery sling without cardiopulmonary bypass: a case report. Anaesth. pain intensive care 2023;27(6):776−779; DOI: 10.35975/apic.v27i6.2352 Received: August 10, 2023; Reviewed: October 16, 2023; Accepted: October 30, 2023

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Section: Discussionmentioning

confidence: 99%

Anesthetic challenges during repairing left pulmonary artery sling without cardiopulmonary bypass: a case report

Arifin,

Perdana

2023

Anaesth. pain intensive care

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“…Cryotherapy uses liquid nitrogen or carbon dioxide to damage the lesion tissues, and induces necrosis of the lesion through low temperature, which is not easy to cause complications such as bronchial perforation. However, the cryotherapy has limited freezing depth to lesion tissues, so it’s not promising for clearing large tumor tissues, and relieving airway stenosis [14, 15]. Argon plasma coagulation can damage the lesion tissues from various angles, which effectively clears the tumor tissues [16].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of argon plasma coagulation combined with cryotherapy for central airway stenosis caused by lung cancer

Wang

2019

J Cardiothorac Surg

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Background: This study aimed to study the clinical efficacy of argon plasma coagulation plus cryotherapy for central airway stenosis caused by lung cancer. Methods: The clinical data of 177 patients with central airway stenosis caused by lung cancer received surgery from June, 2017 to July 2018 were retrospectively analyzed. According to different treatments, 43 patients received cryotherapy were included in the control group, while 134 patients received argon plasma coagulation plus cryotherapy were in the observation group. After propensity score matching, patients in the two groups were in a 1:1 ratio. The Karnofsky score, partial pressure of oxygen (PaO 2), arterial oxygen saturation (SaO 2), partial pressure of arterial carbon dioxide (PaCO 2) and adverse reactions in patients were analyzed one week before and after treatment. Besides, the survival rates of the two groups were compared. Results: After propensity score matching, the baseline data were not significantly different between the two groups. The post-treatment Karnofsky scores in the two groups were significantly higher than those of before treatment, and the post-treatment score of the observation group was higher than that of the control group (all P < 0.05). The posttreatment PaO 2 and SaO 2 in the observation group were both higher than those of the control group; while the PaCO 2 in the observation group was significantly lower than that of the control group (all P < 0.05). In the observation group, the levels of PaO 2 and SaO 2 were significantly higher, and the level of PaCO 2 was significantly lower after treatment than those of before treatment (all P < 0.05). The rates of completely effective and mild effective in the observation group were significantly higher than those in the control group (both P < 0.05). The incidences of bleeding, arrhythmia and fever in the observation group were significantly lower than those in the control group (all P < 0.05). The survival rate was significantly higher in the observation group (72.09%) than in the control group (51.16%). Conclusions: Argon plasma coagulation combined with cryotherapy can significantly alleviate the central airway stenosis caused by lung cancer, reduce the incidence of adverse reactions, and improve prognosis in patients.

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“…However, local lung function has been utilized to assess the remaining lung function after pulmonary resection by measuring the partial pressure of carbon dioxide (PCO 2 ) from expiratory gas via bronchoscopy 3) . Furthermore, Nishine et al reported that intrabronchial capnography could to predict the outcome of stent implantation by assessing ventilation/ perfusion status 4) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Regional Pulmonary Function Using a Bronchoscopic Capnometer in Patients with COPD

Matsuzawa

Nishine

Kida

et al. 2019

J St. Marianna Univ

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Background: Partial pressure of carbon dioxide (PCO 2) measured by capnometer is mainly used to evaluate the respiratory condition of the lungs under ventilator control. Recently, the use of bronchoscopy has been reported in the evaluation of lung function after lobectomy in patients with lung cancer and those with chronic obstructive pulmonary disease (COPD), who underwent bronchoscopic lung volume reduction (BLVR). Objectives: To determine the usefulness of bronchoscopic capnometry to assess treatment sites for BLVR. Method: Twenty patients with COPD suspected of having lung cancer who underwent transbronchial biopsy were included. PCO 2 was measured at the healthy side of the segmental bronchus under room air with a capnometer. Distribution of the percentage of low attenuation area (%LAA) as measured by chest computed tomography (CT), was calculated and compared to end-tidal CO 2 (EtCO 2) distribution obtained by the capnometer. Results: All 20 patients displayed homogeneous patterns on CT, but the distribution of EtCO 2 as measured by capnometer was uneven in 3 patients. There was no significant correlation between %LAA and EtCO 2 in the 20 patients, but in 9 patients with higher %LAA values, %LAA correlation significantly with EtCO 2 (r = −0.437, p = 0.023). Conclusions: Capnography was useful in physiologically evaluating local ventilation and perfusion status of the lung. We recommend capnography as an adjunct to CT to assess functional heterogeneity in patients potentially undergoing BLVR.

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Pulmonary Perfusion Using Intrabronchial Capnography in Pulmonary Artery Stenosis

Cited by 3 publications

References 11 publications

Anesthetic challenges during repairing left pulmonary artery sling without cardiopulmonary bypass: a case report

Anesthetic challenges during repairing left pulmonary artery sling without cardiopulmonary bypass: a case report

Clinical efficacy of argon plasma coagulation combined with cryotherapy for central airway stenosis caused by lung cancer

Evaluation of Regional Pulmonary Function Using a Bronchoscopic Capnometer in Patients with COPD

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