A single center experience of anesthetic management for lung transplantation

To summarize anesthetic management experience during lung transplantation, and to explore the influence of anesthetic management on the outcome of lung transplantation. The clinical data of 19 patients received lung transplantation in Renmin Hospital of Wuhan University from December 2016 to December 2020 were retrospectively analyzed. A total of 19 patients with American Society of Anesthesiologists(ASA)physical status Ⅳ-Ⅴ underwent lung transplantation, and color Doppler echocardiography showed pulmonary artery systolic pressure >70 mmHg in 6 cases, 50-70 mmHg in 5 cases and 30-50 mmHg in 5 cases. There were 12 cases of double lung transplantation, 4 cases of left single lung transplantation and 3 cases of right single lung transplantation.9 cases were under extracorporeal membrane oxygenation(ECMO) assist for surgery. Among them, 2 cases were under ECMO assist in intensive care unit(ICU) before surgery. There were 6 deaths during the perioperative period:3 cases died of multiple organ disfunction disease, 1 dead of graft failure, and 1 died of cardiac arrest during surgery, 1 case was discharged due to a postoperative myocardial infarction and the remaining 13 cases were cured and discharged. Lung transplantation is an effective method for the treatment of end-stage lung disease. Elderly patients with poor cardiopulmonary function have a significantly increased perioperative mortality. Stratrgies such as suitable adjustments before surgery, attention to the underlying diseases, precise intraoperative management, and properly and timely ECMO assistance, may improve the outcome of lung transplantation and reduce perioperative mortality.