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タイトル: | The clinical course of anesthetic induction in lung transplant recipients with pulmonary complications after hematopoietic stem cell transplantation |
著者: | Mizota, Toshiyuki https://orcid.org/0000-0003-2770-4262 (unconfirmed) Matsukawa, Shino Fukagawa, Hiroshi Daijo, Hiroki Tanaka, Tomoharu Chen, Fengshi Date, Hiroshi Fukuda, Kazuhiko |
著者名の別形: | 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 |
キーワード: | Lung transplantation Hematopoietic stem cell transplantation (HSCT) Anesthesia Dynamic compliance Oxygen desaturation |
発行日: | Aug-2015 |
出版者: | Springer Japan |
誌名: | Journal of Anesthesia |
巻: | 29 |
号: | 4 |
開始ページ: | 562 |
終了ページ: | 569 |
抄録: | 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. |
著作権等: | 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(出版社版): | 10.1007/s00540-015-1986-z |
PubMed ID: | 25697269 |
出現コレクション: | 学術雑誌掲載論文等 |
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