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Anesthetic Management of Lung Transplantation: Results from a Multi-Center, Cross-Sectional Survey by the Society for Advancement of Transplant Anesthesia Clinical Transplantation

Date

06/01/2020

Abstract

Background:

Current protocols for the perioperative care of lung transplant (LTX) recipients lack rigorous evidence and are often empiric, based upon institutional preferences. We surveyed LTX anesthesiologists to determine the most common practices.

Methods:

We developed an online survey using Qualtrics’ software that included 40 questions regarding perioperative care of LTX recipients. The survey was sent out to members of the Society of Cardiovascular Anesthesiologists performing LTX at geographically diverse sites to facilitate data collection for as many practices as possible.

Results:

A total of 135 LTX anesthesiologists completed the survey; the responses were center-weighed (127 responses with identifiable centers); most (85%) practiced in academic settings. The clamshell approach was commonly used (70%) and full CPB was preferred by 56 % of the respondents. Most (69%) used oximetric pulmonary artery catheters, 60% used tissue oximetry, and 89.3% utilized transesophageal echocardiography (TEE). Inhaled nitric oxide was preferred pulmonary vasodilator for 48% of respondents, restrictive fluid management used by 48%, and systemic analgesia advocated by 49% of participants. Low tidal volume (5-8 ml/kg) and FiO2 < 30% were applied to the new lung by 51% and 28% of the responses, respectively.

Author List

Kathirvel Subramaniam MD MPH FASE 1 , J Mauricio Del Rio MD 2 , Barbara J Wilkey MD 3 , Akshay Kumar MD 4 , Justin N Tawil MD 5 , Sudhakar Subramani MBBS FASE 6 , Pablo G Sanchez MD Phd FACS 7 , Susan M Mandell MD Phd

Author

Justin N. Tawil MD Assistant Professor in the Anesthesiology department at Medical College of Wisconsin
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