[Anesthesiological problems in the surgical treatment of chronic obstructive pulmonary disease].
Maintenance of effective gas exchange made with respect to surgical comfort and lower risk of intraoperative lung damage is the main problem in the anesthetic management of surgical reduction of pulmonary volume (SRPV). Described in the paper is the experience of anesthetic management made in 10 patients in SPRV. The method of differential ALV (DALV) with continuous positive pressure in airways (CPPA) made for the ventilation support of the independent lung was found to be the only effective technique ensuring an adequate gas exchange in surgery for SPRV in patients with diffusive pulmonary emphysema (DPE). It accounts for the pathophysiological specificity of diffusive pulmonary lesion. At the same time, it provides for an optimal surgical comfort and for the most cautious manipulations on the lung. Such a combination improves the overall surgical results. The high-frequency respiratory support to the operated lung is contraindicated in such patients because of hyperinflation of the affected lung.
Vyzhigina
M A
MA
Fedorova
E A
EA
Bazarov
D V
DV
Zhukova
S G
SG
Titov
V A
VA
Godin
A V
AV
Buniatian
A A
AA
D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D001784:Blood Gas Analysis; D045422:Continuous Positive Airway Pressure; D004452:Echocardiography; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D013510:Pulmonary Surgical Procedures; D012123:Pulmonary Ventilation / Q000502:physiology; D012131:Respiratory Insufficiency / Q000150:complications / Q000503:physiopathology / Q000601:surgery