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KMID : 0377619730240060681
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Korean Jungang Medical Journal
1973 Volume.24 No. 6 p.681 ~ p.685
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Anesthesia for Pulmonary Patients
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Abstract
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Acute pulmonary edema is one of the serious problems encountered during anesthesia. The basical knowledge’s about the effective anesthesia maintenance, oxygenation of capillary blood of the edematous pulmonary alveoli and the treatment of pulmonary edema are mandatory. Also the understandings of gas physics, hydrostatics of blood, and various mechanisms which brought about pulmonary edema, are important. When such patients were no-t an emergency case, it would be recommended to postpone the surgery until the condition of the pulmonary edema were controlled.
Reports have shown how the pattern of mechanical ventilation of the lung affects to the efficiency of pulmonary gas exchange. In dogs with artificial pulmonary edema, Burham, Martin and Cheney found that the application of tidal volume of 15 ml/kg by continuous positive pressure ventilation (CPPV) method were more effective than tidal volume of 24 ml/kg by intermittent positive pressure ventilation (IPPV) method in improving arterial oxygen tension (PaO2). The high effective oxygenation of alveolar blood of the pulmonary edema patient is the result of decreased. alveolar collapse during pulmonary, ventilation.
The end expiratory pressure of 10 cm H2O were applied to the patients.
The author performed general anesthesia for the three patients suffering from pulmonary edema. The CPPV method was applied for these cases and end expiratory pressure of 10 cm H2O was maintained during ventilation. The anesthesia was kept at very light level and high oxygen flow technique was applied. Diuretics, digitalis and steroid were administered. All surgeries were performed successfully.
And the anesthetic point of views concerning to pulmonary edema was discussed.
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