Non-intubated anaesthetic technique in open bilobectomy in a patient with severely impaired lung function
| Autor: | Gábor Lebák, Zsolt Szabó, Tamás Tánczos, Zsolt Molnár, József Furák |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Case Report Oxygenation 030204 cardiovascular system & hematology 03 medical and health sciences Bilobectomy 0302 clinical medicine 030228 respiratory system Cardiothoracic surgery Anesthesia medicine Breathing General anaesthesia Thoracotomy Positive pressure ventilation business Lung function |
| Zdroj: | Journal of Thoracic Disease. 10:E275-E280 |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd.2018.04.80 |
| Popis: | General anaesthesia has been the most commonly used method for almost all types of thoracic surgery. Recently, there has been a growing interest in non-intubated anaesthetic techniques. The rationale being, to prevent complications related to general anaesthesia and positive pressure ventilation such as barotrauma or ventilation-perfusion mismatch. We present a case with severely impaired forced expiration volume (26%), carbon monoxide diffusing capacity (26%) and VO2max (13.9 mL/kg/min). According to current guidelines, this patient was suitable to undergo one-lung ventilation only with high risk of morbidity and mortality. Therefore, we chose the non-intubated technique for thoracotomy. Oxygenation was satisfactory throughout, the patient remained hemodynamically stable and the operation was uneventful. Oxygen supplementation was stopped from day 2 and he was discharged on day 7. To our knowledge, this is the first case report where a planned non-intubated method was applied for thoracotomy, and our results suggest that it might be a feasible and safe approach for open thoracotomy in difficult cases where severely impaired lung function indicates that one lung ventilation may carry significant risks. |
| Databáze: | OpenAIRE |
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