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Title: The clinical course of anesthetic induction in lung transplant recipients with pulmonary complications after hematopoietic stem cell transplantation
Authors: Mizota, Toshiyuki  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0003-2770-4262 (unconfirmed)
Matsukawa, Shino
Fukagawa, Hiroshi  kyouindb  KAKEN_id
Daijo, Hiroki
Tanaka, Tomoharu  kyouindb  KAKEN_id
Chen, Fengshi
Date, Hiroshi
Fukuda, Kazuhiko  kyouindb  KAKEN_id
Author's alias: 溝田, 敏幸
松川, 志乃
深川, 博志
大条, 紘樹
田中, 具治
陳, 豊史
伊達, 洋至
福田, 和彦
Keywords: Lung transplantation
Hematopoietic stem cell transplantation (HSCT)
Anesthesia Dynamic compliance
Oxygen desaturation
Issue Date: Aug-2015
Publisher: Springer Japan
Journal title: Journal of Anesthesia
Volume: 29
Issue: 4
Start page: 562
End page: 569
Abstract: Purpose: We examined the clinical course of anesthetic induction in lung transplant recipients with pulmonary complications after hematopoietic stem cell transplantation (post-HSCT), focusing on ventilatory management. We aimed to determine the incidence of oxygen desaturation during anesthetic induction and severe respiratory acidosis after anesthetic induction in post-HSCT lung transplant recipients, and to explore factors associated with their development. Methods: Nineteen consecutive patients who underwent lung transplantation post-HSCT at Kyoto University Hospital (Japan) were retrospectively studied. Data regarding patient characteristics, preoperative examination, and clinical course during anesthetic induction were analyzed. Results: The incidence of oxygen desaturation (SpO<inf>2</inf> < 90 %) during anesthetic induction and severe respiratory acidosis (pH < 7.2) after anesthetic induction were 21.1 and 26.3 %, respectively. Reduced dynamic compliance (Cdyn) during mechanical ventilation was significantly associated with oxygen desaturation during anesthetic induction (p = 0.01), as well as severe respiratory acidosis after anesthetic induction (p = 0.01). The preoperative partial pressure of carbon dioxide in arterial blood (PaCO<inf>2</inf>; r = −0.743, p = 0.002) and body mass index (BMI; r = 0.61, p = 0.021) significantly correlated with Cdyn, and multivariate analysis revealed that both PaCO<inf>2</inf> and BMI were independently associated with Cdyn. Conclusions: Oxygen desaturation during anesthetic induction and severe respiratory acidosis after anesthetic induction frequently occur in post-HSCT lung transplant recipients. Low Cdyn may, at least partially, explain oxygen desaturation during anesthetic induction and severe respiratory acidosis after anesthetic induction. Moreover, preoperative hypercapnia and low BMI were predictive of low Cdyn.
Rights: The final publication is available at Springer via http://doi.org/10.1007/s00540-015-1986-z
The full-text file will be made open to the public on 01 August 2016 in accordance with publisher's 'Terms and Conditions for Self-Archiving'
This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
URI: http://hdl.handle.net/2433/226009
DOI(Published Version): 10.1007/s00540-015-1986-z
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