气候变化领域集成服务门户(CCPortal): Intraoperative oxygen challenge for toleration of single lung ventilation in a patient with severe obstructive airway disease: A case report

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DOI	10.1016/j.amsu.2019.10.032
	Intraoperative oxygen challenge for toleration of single lung ventilation in a patient with severe obstructive airway disease: A case report
	Weinberg L.; Cosic L.; Louis M.; Garry T.; Lloyd-Donald P.; Barnett S.; Miles L.F.
发表日期	2020
ISSN	20490801
起始页码	28
结束页码	32
卷号	49
英文摘要	Perioperative risk assessment is complex in patients with chronic obstructive pulmonary disease who have undergone previous lung resection surgery. A 70-year-old female with severe chronic obstructive pulmonary disease and previous right middle and lower lobectomy, presented for left lower lobe superior segmentectomy. Respiratory function tests revealed a forced expiratory volume in 1 second of 0.72L, a forced vital capacity of 1.93L, and a carbon monoxide transfer factor of 10.0 ml/min/mmHg. A cardiopulmonary exercise test demonstrated little ventilatory reserve with profound arterial desaturation on peak exercise, however, a normal peak oxygen consumption (16.7 ml/min/kg) and a nadir minute ventilation/carbon dioxide slope of 24 implied a limited risk of perioperative cardiovascular morbidity. Given these conflicting results we performed an intraoperative oxygen challenge test under general anaesthesia with sequential ventilation of different lobes of the lung. We demonstrate the use of the oxygen challenge test as an effective intervention to further assess safety and tolerance of anaesthesia of patients with limited respiratory reserve being assessed for further complex redo lung resection surgery. Further, this test was a risk stratification tool that allowed informed decisions to be made by the patient about therapeutic options for treating their lung cancer. The prognostic value of traditional physiological parameters in patients with chronic obstructive pulmonary disease who have undergone previous lung resection surgery is uncertain. The intraoperative oxygen challenge test is another risk stratification tool to assist clinicians in assessment of safety and tolerance of anaesthesia for patients being considered for lung resection. The Authors
英文关键词	Anaesthesia; Bronchial blocker; Case report; Risk stratification; Thoracic surgery
scopus关键词	formoterol fumarate; ipratropium bromide; oxygen; quetiapine; rocuronium; salbutamol sulfate; sevoflurane; tiotropium bromide; vitamin D; aged; anaerobic threshold; Article; cancer radiotherapy; cardiopulmonary exercise test; case report; clinical article; comorbidity; computer assisted tomography; depression; Edmonton Frail Scale; female; forced expiratory volume; home rehabilitation; human; lung function test; lung lobectomy; lung minute volume; lung perfusion; lung scintiscanning; obstructive airway disease; one lung ventilation; oxygen consumption; paralysis; positive end expiratory pressure; positron emission tomography; priority journal; respiratory failure; schizophrenia; segmentectomy; squamous cell lung carcinoma; stereotactic treatment
来源期刊	Annals of Medicine and Surgery
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/177045
作者单位	Department of Anaesthesia, Austin Hospital, 145 Studley Road, Victoria, 3084, Australia; Department of Cardiothoracic Surgery, Austin Hospital, 145 Studley Road, Victoria, 3084, Australia
推荐引用方式 GB/T 7714	Weinberg L.,Cosic L.,Louis M.,et al. Intraoperative oxygen challenge for toleration of single lung ventilation in a patient with severe obstructive airway disease: A case report[J],2020,49.
APA	Weinberg L..,Cosic L..,Louis M..,Garry T..,Lloyd-Donald P..,...&Miles L.F..(2020).Intraoperative oxygen challenge for toleration of single lung ventilation in a patient with severe obstructive airway disease: A case report.Annals of Medicine and Surgery,49.
MLA	Weinberg L.,et al."Intraoperative oxygen challenge for toleration of single lung ventilation in a patient with severe obstructive airway disease: A case report".Annals of Medicine and Surgery 49(2020).