Management of Anesthesia during Lung Transplantations in a Single Turkish Center

dc.authorid0000-0001-9531-4317en_US
dc.contributor.authorAyazoğlu, Tülün Akarsu
dc.contributor.authorÖzensoy, Aynur
dc.contributor.authorBaysal, Ayşe
dc.contributor.authorGül, Yaşar G.
dc.contributor.authorOnk, Didem
dc.contributor.authorOnk, Alper
dc.date.accessioned2021-03-18T06:56:51Z
dc.date.available2021-03-18T06:56:51Z
dc.date.issued2016-04-19
dc.description.abstractAim: The aim of this study is to present our institutional experience during the management of anesthesia in lung transplantation (LT) surgeries as a definitive surgical treatment option in end-stage lung diseases. Methods: From a total of 15 patients, lung transplantation was performed as single LT (SLT) in 4 patients (n = 4) and as sequential bilateral LT (BLT) in 11 patients (n = 11). The anesthetic management included; for induction; intravenous ketamine, midazolam at doses of 2 mg/kg, 0.05 mg/kg, respectively or propofol, fentanyl at doses of 1 mg/kg, 3 mcg/kg, respectively. For maintenance, all patients received; 100% O2 and total intravenous infusion of propofol and remifentanil at doses of 0.02 mcg/kg/min and 0.1-0.25 µg/kg/min, respectively. All patients received intravenous rocuronium bromide for induction and maintenance. Hemodynamic stability was maintained with appropriate and adequate administration of vasodilators (intravenous Prostaglandin (PGI2) (0.5-1 ng/kg/min), inhaled nitric oxide (10-40 ppm), dopamine (2 mcg/kg/min) and vasopressors (intravenous dobutamine (5-15 mcg/kg/min), norepinephrine (0.05-1 mcg/kg/min),ephedrine (5 to 10 mg bolus doses ) to keep mean arterial blood pressure above 50 mmHg. Results: Cardiopulmonary bypass (CPB) was performed in five patients who underwent sequential BLT and one SLT case. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) was used in four cases of sequential BLT and in two cases of SLT. Neither ECMO nor CPB was performed in two BLT and in one SLT patient. One SLT patient who underwent CPB was admitted to the intensive care unit with support of intra-aortic balloon pump (IABP) and ECMO. Intraoperative death did not occur. Conclusion: During SLT or BLT, management of anesthesia with propofol and remifentanil provides a stable hemodynamic and medical support. Although our experience with VA ECMO was limited, our experience shows that this support system is a valuable tool to provide hemodynamic stability for patients undergoing LT.en_US
dc.fullTextLevelFull Texten_US
dc.identifier.pmid27041521en_US
dc.identifier.urihttps://hdl.handle.net/11411/3417
dc.identifier.wosWOS:000372286600005en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.issue4en_US
dc.language.isoenen_US
dc.nationalInternationalen_US
dc.numberofauthors6en_US
dc.pages262-268en_US
dc.publisherArchives of Iranian Medicineen_US
dc.relation.ispartofArch Iran Meden_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAnesthesiaen_US
dc.subjecthemodynamicsen_US
dc.subjectung transplantationen_US
dc.titleManagement of Anesthesia during Lung Transplantations in a Single Turkish Centeren_US
dc.typeArticleen_US
dc.volume19en_US

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