Review Note
Last Update: 02/27/2025 04:36 AM
Current Deck: ACG Part 2::Thoracic SSU
New Card (Unpublished)Currently Published Content
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Commit #291089
SS_TS 1.20 Outline the critical times during thoracic procedures that will impact on anaesthesia management, including airway ligation and manipulation of pulmonary vasculature
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Commit #291089
Critical times include :
- Airway ligation
- Changing position
- Lung reinflation
- Surgical manipulation
- Clamping of the PA
Airway ligation: Important to know where your tube/bronchial blocker is
Changing position: Moving lateral - common for DLT or BB to become dislodged/migrate, so reassess with fibreoptic after repositioning
Lung reinflation: Will need to re-recruit due to atelectasis, and check for air leaks following lobectomy/pneumonectomy
Surgical manipulation: Often causes cardiac and venous compression which reduces CO/BP/arrhythmias - requires good communication between surgeon and anaesthetist re: timing
Clamping of PA: ALL CO suddenly through one lung, large degree of cardiac instability, have vasopressors available, often need rapid calcium, RV support, may need dilators