Pre-anaesthetic evaluation of the patient with end-stage lung disease

Best Pract Res Clin Anaesthesiol. 2017 Jun;31(2):249-260. doi: 10.1016/j.bpa.2017.05.002. Epub 2017 May 17.

Abstract

Lung transplantation is a viable alternative for end-stage lung diseases, which offers good quality of life and survival outcomes for recipients. The aims of pre-assessment for potential lung transplant recipients are to assess fitness for surgery, optimise co-morbidities, commence interventions or investigations, weigh risk-benefit ratio, plan appropriate analgesia and obtain informed consent. The assessment information is gathered from the medical record, patient interview, physical examination and pre-operative tests. A comprehensive workup includes cardiopulmonary evaluation, haematological, biochemical, microbiological and immunological investigations. Most of the evidence regarding lung transplantation is gleaned from retrospective data from single, multi-centre or multinational registries. The lack of good quality evidence means that the guidelines are based on expert consensus.

Keywords: end-stage lung disease; lung transplantation; pre-anaesthetic assessment.

Publication types

  • Review

MeSH terms

  • Anesthesia / methods*
  • Anesthetics / administration & dosage*
  • Cystic Fibrosis / diagnosis
  • Cystic Fibrosis / physiopathology
  • Cystic Fibrosis / surgery
  • Humans
  • Lung Diseases / diagnosis*
  • Lung Diseases / physiopathology
  • Lung Diseases / surgery*
  • Lung Transplantation / methods*
  • Preoperative Care / methods*
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / surgery
  • Tissue and Organ Procurement / methods

Substances

  • Anesthetics