Advertisement

Pulmonary Resection in the Patient with Pulmonary Hypertension

  • Alexander HuangEmail author
  • Katherine Marseu
Chapter

Abstract

Pulmonary hypertension is a significant medical condition, with a global prevalence estimated as high as 1%. As such, it is no longer an uncommon occurrence for patients with pulmonary hypertension to present for surgery. Pulmonary resection in the patient with pulmonary hypertension has long been considered high risk and discouraged in early literature. The morbidity and mortality associated with pulmonary hypertension in patients presenting for surgery have been quoted as high as 42% and 18%, respectively. In this chapter, we review the perioperative management of patients with pulmonary hypertension presenting for pulmonary resection. This includes the preoperative assessment, pharmacology as it relates to pulmonary hypertension (both preoperative and intraoperative), anesthetic management (including management intraoperatively, monitoring, and a discussion of ventilation and analgesic strategies), and postoperative care. An example clinical case is presented at the end of the chapter to integrate this information.

Keywords

Pulmonary hypertension Pulmonary resection Lung resection Lobectomy Pneumonectomy Segmentectomy Pulmonary vascular resistance Pulmonary arterial pressure Pulmonary artery catheter Transesophageal echocardiography One-lung ventilation 

Abbreviations

ARDS

Acute respiratory distress syndrome

ECG

Electrocardiogram

ECMO

Extracorporeal membrane oxygenation

ERA

Endothelin receptor antagonist

iNO

Inhaled nitric oxide

NYHA

New York Heart Association

OLV

One-lung ventilation

PAC

Pulmonary artery catheter

PAP or PA pressure

Pulmonary artery pressure

PCA

Patient-controlled analgesia

PDE-5

Phosphodiesterase-5

PGI2

Prostacyclin

RHC

Right heart catheterization

RVSP

Right ventricular systolic pressure

SPAP

Systolic pulmonary artery pressure

TEE

Transesophageal echocardiography

TTE

Transthoracic echocardiography

VATS

Video-assisted thoracoscopic surgery

WHO

World Health Organization

References

  1. 1.
    Hoeper MM, Bogaard HJ, Condliffe R, Frantz R, Khanna D, Kurzyna M, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol Elsevier Inc. 2013;62(S):D42–50.CrossRefGoogle Scholar
  2. 2.
    Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. Elsevier Inc. 2013;62(S):D34–41.CrossRefGoogle Scholar
  3. 3.
    Hoeper MM, Humbert M, Souza R, Idrees M, Kawut SM, Sliwa-Hahnle K, et al. A global view of pulmonary hypertension. Lancet Respir Med Elsevier Ltd. 2016;4(4):306–22.CrossRefGoogle Scholar
  4. 4.
    Kaw R, Pasupuleti V, Deshpande A, Hamieh T, Walker E, Minai OA. Pulmonary hypertension: an important predictor of outcomes in patients undergoing non-cardiac surgery. Respir Med Elsevier Ltd. 2011;105(4):619–24.CrossRefGoogle Scholar
  5. 5.
    Lai HC, Lai HC, Wang KY, Lee WL, Ting CT, Liu TJ. Severe pulmonary hypertension complicates postoperative outcome of non-cardiac surgery. Br J Anaesth. 2007;99(2):184–90.PubMedCrossRefGoogle Scholar
  6. 6.
    Ramakrishna G, Sprung J, Ravi BS, Chandrasekaran K, MD MG. Impact of pulmonary hypertension on the outcomes of noncardiac surgery. J Am Coll Cardiol. Elsevier Masson SAS. 2005;45(10):1691–9.CrossRefGoogle Scholar
  7. 7.
    Pilkington SA, Taboada D, Martinez G. Pulmonary hypertension and its management in patients undergoing non-cardiac surgery. Anaesthesia. 2014;70(1):56–70.PubMedCrossRefGoogle Scholar
  8. 8.
    Nicod P, Moser KM. Primary pulmonary hypertension. The risk and benefit of lung biopsy. Circulation. 1989;80(5):1486–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Kreider ME, Hansen-Flaschen J, Ahmad NN, Rossman MD, Kaiser LR, Kucharczuk JC, et al. Complications of video-assisted thoracoscopic lung biopsy in patients with interstitial lung disease. Ann Thorac Surg. 2007;83(3):1140–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Hasegawa S, Isowa N, Bando T, Wada H. The inadvisability of thoracoscopic lung biopsy on patients with pulmonary hypertension. CHEST The American College of Chest Physicians. 2016;122(3):1067–8.Google Scholar
  11. 11.
    Heller AR. A fine balance--one-lung ventilation in a patient with Eisenmenger syndrome. Br J Anaesth. 2004;92(4):587–90.PubMedCrossRefGoogle Scholar
  12. 12.
    Cheng DC, Edelist G. Isoflurane and primary pulmonary hypertension. Anaesthesia. 1988;43(1):22–4.PubMedCrossRefGoogle Scholar
  13. 13.
    Ichinokawa M, Hida Y, Kaga K, Kawada M, Niizeki H, Kondo S. A case of primary pulmonary hypertension with pulmonary tumor. Ann Thorac Cardiovasc Surg. 2010;16(4):270–2.PubMedGoogle Scholar
  14. 14.
    Wei B, D'Amico T, Samad Z, Hasan R, Berry MF. The impact of pulmonary hypertension on morbidity and mortality following major lung resection. Eur J Cardiothorac Surg. 2014;45(6):1028–33.PubMedCrossRefGoogle Scholar
  15. 15.
    Ota T, Okada M, Matsuda H, Okada K, Ishii N. Right ventricular dysfunction after major pulmonary resection. J Thorac Cardiovasc Surg. 1994;108(3):503–11.PubMedGoogle Scholar
  16. 16.
    Kowalewski J, Brocki M, Dryjański T, Kaproń K, Barcikowski S. Right ventricular morphology and function after pulmonary resection. Eur J Cardiothorac Surg. 1999;15(4):444–8.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Venuta F, Sciomer S, Andreetti C, Anile M, De Giacomo T, Rolla M, et al. Long-term Doppler echocardiographic evaluation of the right heart after major lung resections. Eur J Cardiothorac Surg. 2007;32(5):787–90.CrossRefGoogle Scholar
  18. 18.
    Pedoto A, Amar D. Right heart function in thoracic surgery: role of echocardiography. Curr Opin Anaesthesiol. 2009;22(1):44–9.CrossRefGoogle Scholar
  19. 19.
    Barst RJ, McGoon M, Torbicki A, Sitbon O, Krowka MJ, Olschewski H, et al. Diagnosis and differential assessment of pulmonary arterial hypertension. J Am Coll Cardiol. Elsevier Masson SAS. 2004;43(12):S40–7.CrossRefGoogle Scholar
  20. 20.
    McLaughlin VV. Survival in primary pulmonary hypertension: the impact of epoprostenol therapy. Circulation. 2002;106(12):1477–82.PubMedCrossRefGoogle Scholar
  21. 21.
    Fisher MR, Forfia PR, Chamera E, Housten-Harris T, Champion HC, Girgis RE, et al. Accuracy of Doppler echocardiography in the hemodynamic assessment of pulmonary hypertension. Am J Respir Crit Care Med. 2009;179(7):615–21.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Bossone E, D'Andrea A, D'Alto M, Citro R, Argiento P, Ferrara F, et al. Echocardiography in pulmonary arterial hypertension: from diagnosis to prognosis. J Am Soc Echocardiogr. Elsevier Inc. 2013;26(1):1–14.CrossRefGoogle Scholar
  23. 23.
    Luscher TF, Barton M. Endothelins and endothelin receptor antagonists : therapeutic considerations for a novel class of cardiovascular drugs. Circulation. 2000;102(19):2434–40.PubMedCrossRefGoogle Scholar
  24. 24.
    Frumkin LR. The pharmacological treatment of pulmonary arterial hypertension. Pharmacol Rev. 2012;64(3):583–620.PubMedCrossRefGoogle Scholar
  25. 25.
    Montani D, Gunther S, Dorfmüller P, FDR P, Girerd B, Garcia G, et al. Pulmonary arterial hypertension. Orphanet J Rare Dis. 2013;8(1):1–1.CrossRefGoogle Scholar
  26. 26.
    Badesch DB, McLaughlin VV, Delcroix M, Vizza C, Olschewski H, Sitbon O, et al. Prostanoid therapy for pulmonary arterial hypertension. J Am Coll Cardiol Elsevier Masson SAS. 2004;43(12):S56–61.CrossRefGoogle Scholar
  27. 27.
    LeVarge B. Prostanoid therapies in the management of pulmonary arterial hypertension. TCRM. 2015;11:535–13.CrossRefGoogle Scholar
  28. 28.
    Wilkins MR, Wharton J, Grimminger F, Ghofrani HA. Phosphodiesterase inhibitors for the treatment of pulmonary hypertension. Eur Respir J. 2008;32(1):198–209.PubMedCrossRefGoogle Scholar
  29. 29.
    Wilcox SR, Kabrhel C, Channick RN. Pulmonary hypertension and right ventricular failure in emergency medicine. Ann Emerg Med. 2015;66(6):619–28.PubMedCrossRefGoogle Scholar
  30. 30.
    Polanczyk CA, Rohde LE, Goldman L, Cook EF, Thomas EJ, Marcantonio ER, et al. Right heart catheterization and cardiac complications in patients undergoing noncardiac surgery: an observational study. JAMA. 2001;286(3):309–14.PubMedCrossRefGoogle Scholar
  31. 31.
    Sandham JD, Hull RD, Brant RF, Knox L, Pineo GF, Doig CJ, et al. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med. 2003;348(1):5–14.PubMedCrossRefGoogle Scholar
  32. 32.
    Marik PE. Obituary: pulmonary artery catheter 1970 to 2013. Ann Intensive Care. 2013;3(1):38.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Kalra A, Heitner S, Topalian S. Iatrogenic pulmonary artery rupture during swan-Ganz catheter placement--a novel therapeutic approach. Catheter Cardiovasc Interv. 2013;81(1):57–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Kolev N, Brase R, Swanevelder J, Oppizzi M, Riesgo MJ, van der Maaten JM, et al. The influence of transoesophageal echocardiography on intra-operative decision making. A European multicentre study. European perioperative TOE research group. Anaesthesia. 1998;53(8):767–73.PubMedCrossRefGoogle Scholar
  35. 35.
    Hofer CK, Zollinger A, Rak M, Matter-Ensner S, Klaghofer R, Pasch T, et al. Therapeutic impact of intra-operative transoesophageal echocardiography during noncardiac surgery. Anaesthesia. 2004;59(1):3–9.PubMedCrossRefGoogle Scholar
  36. 36.
    American Society of Anesthesiologists and Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Practice guidelines for perioperative transesophageal echocardiography. An updated report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on transesophageal echocardiography. Anesthesiology. 2010;112:1084–96.Google Scholar
  37. 37.
    Ternacle J, Berry M, Cognet T, Kloeckner M, Damy T, Monin JL, et al. Prognostic value of right ventricular two-dimensional global strain in patients referred for cardiac surgery. J Am Soc Echocardiogr Elsevier Inc. 2013;26(7):721–6.CrossRefGoogle Scholar
  38. 38.
    Ostenfeld E, Flachskampf FA. Assessment of right ventricular volumes and ejection fraction by echocardiography: from geometric approximations to realistic shapes. Echo Res Pract. 2015;2(1):R1–R11.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Edanaga M, Nakayama M, Kanaya N, Tohse N, Namiki A. Propofol increases pulmonary vascular resistance during alpha-adrenoreceptor activation in normal and monocrotaline-induced pulmonary hypertensive rats. Anesth Analg. 2007;104(1):112–8.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Kondo U, Kim SO, Nakayama M, Murray PA. Pulmonary vascular effects of propofol at baseline, during elevated vasomotor tone, and in response to sympathetic alpha- and beta-adrenoreceptor activation. Anesthesiology. 2001;94(5):815–23.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Ouédraogo N, Mounkaïla B, Crevel H, Marthan R, Roux E. Effect of propofol and etomidate on normoxic and chronically hypoxic pulmonary artery. BMC Anesthesiol. 2006 Mar;6(1):715–0.CrossRefGoogle Scholar
  42. 42.
    Komatsu R, You J, Mascha EJ, Sessler DI, Kasuya Y, Turan A. Anesthetic induction with etomidate, rather than propofol, is associated with increased 30-day mortality and cardiovascular morbidity after noncardiac surgery. Anesth Analg. 2013;117(6):1329–37.PubMedCrossRefGoogle Scholar
  43. 43.
    Kohrs R, Durieux ME. Ketamine: teaching an old drug new tricks. Anesth Analg. 1998;87(5):1186–93.PubMedGoogle Scholar
  44. 44.
    Iadarola ND, Niciu MJ, Richards EM, Vande Voort JL, Ballard ED, Lundin NB, et al. Ketamine and other N-methyl-D-aspartate receptor antagonists in the treatment of depression: a perspective review. Ther Adv Chronic Dis. 2015;6(3):97–114.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Gooding JM, Dimick AR, Tavakoli M, Corssen G. A physiologic analysis of cardiopulmonary responses to ketamine anesthesia in noncardiac patients. Anesth Analg. 1977;56(6):813–6.PubMedGoogle Scholar
  46. 46.
    Tweed WA, Minuck M, Mymin D. Circulatory responses to ketamine anesthesia. Anesthesiology. 1972;37(6):613–9.PubMedCrossRefGoogle Scholar
  47. 47.
    Maxwell BG, Jackson E. Role of ketamine in the management of pulmonary hypertension and right ventricular failure. J Cardiothorac Vasc Anesth Elsevier Inc. 2012;26(3):e24–5.CrossRefGoogle Scholar
  48. 48.
    Williams GD, Philip BM, Chu LF, Boltz MG, Kamra K, Terwey H, et al. Ketamine does not increase pulmonary vascular resistance in children with pulmonary hypertension undergoing sevoflurane anesthesia and spontaneous ventilation. Anesth Analg. 2007;105(6):1578–84.PubMedCrossRefGoogle Scholar
  49. 49.
    Williams GD, MAAN H, Ramamoorthy C, Kamra K, BRATTON SL, BAIR E, et al. Perioperative complications in children with pulmonary hypertension undergoing general anesthesia with ketamine. Pediatr Anesth. 2010;20(1):28–37.CrossRefGoogle Scholar
  50. 50.
    Kaye AD, Banister RE, Fox CJ, Ibrahim IN, Nossaman BD. Analysis of ketamine responses in the pulmonary vascular bed of the cat. Crit Care Med. 2000;28(4):1077–82.PubMedCrossRefGoogle Scholar
  51. 51.
    Kerbaul F, Rondelet B, Motte S, Fesler P, Hubloue I, Ewalenko P, et al. Isoflurane and desflurane impair right ventricular-pulmonary arterial coupling in dogs. Anesthesiology. 2004;101(6):1357–62.PubMedCrossRefGoogle Scholar
  52. 52.
    Kerbaul F, Bellezza M, Mekkaoui C, Feier H, Guidon C, Gouvernet J, et al. Sevoflurane alters right ventricular performance but not pulmonary vascular resistance in acutely instrumented anesthetized pigs. J Cardiothorac Vasc Anesth. 2006;20(2):209–16.PubMedCrossRefGoogle Scholar
  53. 53.
    Blaudszun G, Morel DR. Superiority of desflurane over sevoflurane and isoflurane in the presence of pressure-overload right ventricle hypertrophy in rats. Anesthesiology. 2012;117(5):1051–61.PubMedCrossRefGoogle Scholar
  54. 54.
    Pearl RG, Maze M, Rosenthal MH. Pulmonary and systemic hemodynamic effects of central venous and left atrial sympathomimetic drug administration in the dog. J Cardiothorac Anesth. 1987;1(1):29–35.PubMedCrossRefGoogle Scholar
  55. 55.
    Price LC, Wort SJ, Finney SJ, Marino PS, Brett SJ. Pulmonary vascular and right ventricular dysfunction in adult critical care: current and emerging options for management: a systematic literature review. Crit Care BioMed Central. 2010;14(5):R169.CrossRefGoogle Scholar
  56. 56.
    Kerbaul F, Rondelet B, Motte S, Fesler P, Hubloue I, Ewalenko P, et al. Effects of norepinephrine and dobutamine on pressure load-induced right ventricular failure. Crit Care Med. 2004;32(4):1035–40.PubMedCrossRefGoogle Scholar
  57. 57.
    Rich S, Gubin S, Hart K. The effects of phenylephrine on right ventricular performance in patients with pulmonary hypertension. Chest J. 1990;98(5):1102–6.CrossRefGoogle Scholar
  58. 58.
    Leather HA, Segers P, Berends N, Vandermeersch E, Wouters PF. Effects of vasopressin on right ventricular function in an experimental model of acute pulmonary hypertension. Crit Care Med. 2002;30(11):2548–52.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Eichinger MR, Walker BR. Enhanced pulmonary arterial dilation to arginine vasopressin in chronically hypoxic rats. Am J Phys. 1994;267(6 Pt 2):H2413–9.Google Scholar
  60. 60.
    Walker BR, Haynes J, Wang HL, Voelkel NF. Vasopressin-induced pulmonary vasodilation in rats. Am J Phys. 1989;257(2 Pt 2):H415–22.Google Scholar
  61. 61.
    Currigan DA, Hughes RJA, Wright CE, Angus JA, Soeding PF. Vasoconstrictor responses to vasopressor agents in human pulmonary and radial arteries: an in vitro study. Anesthesiology. 2014;121(5):930–6.PubMedCrossRefGoogle Scholar
  62. 62.
    Mizota T, Fujiwara K, Hamada M, Matsukawa S, Segawa H. Effect of arginine vasopressin on systemic and pulmonary arterial pressure in a patient with pulmonary hypertension secondary to pulmonary emphysema: a case report. JA Clinical Reports. 2017;3(1):1–4.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Tayama E, Ueda T, Shojima T, Akasu K, Oda T, Fukunaga S, et al. Arginine vasopressin is an ideal drug after cardiac surgery for the management of low systemic vascular resistant hypotension concomitant with pulmonary hypertension. Interact Cardiovasc Thorac Surg. 2007;6(6):715–9.PubMedCrossRefGoogle Scholar
  64. 64.
    Creagh-Brown BC, Griffiths MJD, Evans TW. Bench-to-bedside review: inhaled nitric oxide therapy in adults. Crit Care. 2009;13(3):221.PubMedPubMedCentralCrossRefGoogle Scholar
  65. 65.
    Adhikari NKJ, Dellinger RP, Lundin S, Payen D, Vallet B, Gerlach H, et al. Inhaled nitric oxide does not reduce mortality in patients with acute respiratory distress syndrome regardless of severity: systematic review and meta-analysis. Crit Care Med. 2014;42(2):404–12.PubMedCrossRefGoogle Scholar
  66. 66.
    Meade MO, Granton JT, Matte-Martyn A, McRae K, Weaver B, Cripps P, et al. A randomized trial of inhaled nitric oxide to prevent ischemia–reperfusion injury after lung transplantation. Am J Respir Crit Care Med. 2003;167(11):1483–9.PubMedCrossRefGoogle Scholar
  67. 67.
    Sim J-Y. Nitric oxide and pulmonary hypertension. Korean J Anesthesiol. 2010;58(1):4–11.PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Skhiri M, Hunt SA, Denault AY, Haddad F. Evidence-based management of right heart failure: a systematic review of an empiric field. Rev Esp Cardiol. 2010;63(4):451–71.PubMedCrossRefGoogle Scholar
  69. 69.
    King R, Esmail M, Mahon S, Dingley J, Dwyer S. Use of nitric oxide for decompensated right ventricular failure and circulatory shock after cardiac arrest. Br J Anaesth. 2000;85(4):628–31.PubMedCrossRefGoogle Scholar
  70. 70.
    Rocca GD, Passariello M, Coccia C, Costa MG, Di Marco P, Venuta F, et al. Inhaled nitric oxide administration during one-lung ventilation in patients undergoing thoracic surgery. J Cardiothorac Vasc Anesth. 2001;15(2):218–23.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Eichhorn EJ, Konstam MA, Weiland DS, Roberts DJ, Martin TT, Stransky NB, et al. Differential effects of milrinone and dobutamine on right ventricular preload, afterload and systolic performance in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1987;60(16):1329–33.PubMedCrossRefGoogle Scholar
  72. 72.
    Laflamme M, Perrault LP, Carrier M, Elmi-Sarabi M, Fortier A, Denault AY. Preliminary experience with combined inhaled milrinone and prostacyclin in cardiac surgical patients with pulmonary hypertension. J Cardiothorac Vasc Anesth. 2015;29(1):38–45.PubMedCrossRefGoogle Scholar
  73. 73.
    Denault AY, Bussières JS, Arellano R, Finegan B, Gavra P, Haddad F, et al. A multicentre randomized-controlled trial of inhaled milrinone in high-risk cardiac surgical patients. Can J Anaesth. 2016;63(10):1140–53.PubMedCrossRefGoogle Scholar
  74. 74.
    Haraldsson Å, Kieler-Jensen N, Ricksten SE. The additive pulmonary vasodilatory effects of inhaled prostacyclin and inhaled milrinone in postcardiac surgical patients with pulmonary hypertension. Anesth Analg. 2001;93(6):1439–45. –tableofcontents.CrossRefGoogle Scholar
  75. 75.
    Bund M, Henzler D, Walz R, Rossaint R, Piepenbrock S, Kuhlen R. Aerosolized and intravenous prostacyclin during one-lung ventilation. Hemodynamic and pulmonary effects. Anaesthesist Springer-Verlag. 2004;53(7):612–20.Google Scholar
  76. 76.
    Bund M, Henzler D, Walz R, Rossaint R, Piepenbrock S. Cardiopulmonary effects of intravenous prostaglandin E 1 during experimental one-lung ventilation. Thorac Cardiovasc Surg. 2006;54(5):341–7.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Haché M, Denault A, Bélisle S, Robitaille D, Couture P, Sheridan P, et al. Inhaled epoprostenol (prostacyclin) and pulmonary hypertension before cardiac surgery. J Thorac Cardiovasc Surg. 2003;125(3):642–9.PubMedCrossRefGoogle Scholar
  78. 78.
    Jerath A, Srinivas C, Vegas A, Brister S. The successful management of severe protamine-induced pulmonary hypertension using inhaled prostacyclin. Anesth Analg. 2010;110(2):365–9.PubMedCrossRefGoogle Scholar
  79. 79.
    Rocca Della G, Coccia C, Costa MG, Pompei L, Pietropaoli P. Inhaled prostacyclin during anaesthesia for lung transplantation. Eur J Anaesthesiol. 2000;17(Supplement 19):130.CrossRefGoogle Scholar
  80. 80.
    Raghunathan K, Connelly NR, Robbins LD, Ganim R, Hochheiser G, DiCampli R. Inhaled epoprostenol during one-lung ventilation. ATS Elsevier Inc. 2010;89(3):981–3.Google Scholar
  81. 81.
    Wu CL, Cohen SR, Richman JM, Rowlingson AJ, Courpas GE, Cheung K, et al. Efficacy of postoperative patient-controlled and continuous infusion epidural analgesia versus intravenous patient-controlled analgesia with opioids: a meta-analysis. Anesthesiology. 2005;103(5):1079–88. –quiz1109–10.PubMedCrossRefGoogle Scholar
  82. 82.
    Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA, Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003;290(18):2455–63.PubMedCrossRefGoogle Scholar
  83. 83.
    Dolin SJ, Cashman JN, Bland JM. Effectiveness of acute postoperative pain management: I. evidence from published data. Br J Anaesth. 2002;89(3):409–23.PubMedCrossRefGoogle Scholar
  84. 84.
    Pöpping DM, Elia N, Marret E, Remy C, Tramèr MR. Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis. Arch Surg. 2008;143(10):990–9. –discussion1000.PubMedCrossRefGoogle Scholar
  85. 85.
    Pöpping DM, Elia N, Van Aken HK, Marret E, Schug SA, Kranke P, et al. Impact of epidural analgesia on mortality and morbidity after surgery. Ann Surg. 2014;259(6):1056–67.PubMedCrossRefGoogle Scholar
  86. 86.
    Ozcan PE, Sentürk M, Sungur Ulke Z, Toker A, Dilege S, Ozden E, et al. Effects of thoracic epidural anaesthesia on pulmonary venous admixture and oxygenation during one-lung ventilation. Acta Anaesthesiol Scand. 2007;51(8):1117–22.PubMedPubMedCentralCrossRefGoogle Scholar
  87. 87.
    Miró M, Sanfilippo F, Pérez F, García Del Valle S, Gómez-Arnau JI. Influence of the thoracic epidural anesthesia on the left ventricular function: an echocardiographic study. Minerva Anestesiol. 2017;83(7):695–704.PubMedGoogle Scholar
  88. 88.
    Schmidt C, Hinder F, Van Aken H, Theilmeier G, Bruch C, Wirtz SP, et al. The effect of high thoracic epidural anesthesia on systolic and diastolic left ventricular function in patients with coronary artery disease. Anesth Analg. 2005;100(6):1561–9.PubMedCrossRefGoogle Scholar
  89. 89.
    Clemente A, Carli F. The physiological effects of thoracic epidural anesthesia and analgesia on the cardiovascular, respiratory and gastrointestinal systems. Minerva Anestesiol. 2008;74(10):549–63.PubMedGoogle Scholar
  90. 90.
    Rex S, Missant C, Segers P, Wouters PF. Thoracic epidural anesthesia impairs the hemodynamic response to acute pulmonary hypertension by deteriorating right ventricular–pulmonary arterial coupling. Crit Care Med. 2007;35(1):222–9.PubMedCrossRefGoogle Scholar
  91. 91.
    Missant C, Rex S, Claus P, Derde S, Wouters PF. Thoracic epidural anaesthesia disrupts the protective mechanism of homeometric autoregulation during right ventricular pressure overload by cardiac sympathetic blockade: a randomised controlled animal study. Eur J Anaesthesiol. 2011;28(7):535–43.PubMedCrossRefGoogle Scholar
  92. 92.
    Wink J, de Wilde RBP, Wouters PF, van Dorp ELA, Veering BT, Versteegh MIM, et al. Thoracic epidural anesthesia reduces right ventricular systolic function with maintained ventricular-pulmonary coupling. Clinical perspective. Circulation. 2016;134(16):1163–75.PubMedCrossRefGoogle Scholar
  93. 93.
    Yeung JH, Gates S, Naidu BV, Wilson MJA, Gao Smith F. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy. Gao Smith F, editor. Cochrane Database Syst Rev. Chichester, UK: John Wiley & Sons, Ltd. 2016;2(4):CD009121.Google Scholar
  94. 94.
    Daly DJ, Myles PS. Update on the role of paravertebral blocks for thoracic surgery: are they worth it? Curr Opin Anaesthesiol. 2009;22(1):38–43.PubMedCrossRefGoogle Scholar
  95. 95.
    Grider JS, Mullet TW, Saha SP, Harned ME, Sloan PA. A randomized, double-blind trial comparing continuous thoracic epidural bupivacaine with and without opioid in contrast to a continuous paravertebral infusion of bupivacaine for post-thoracotomy pain. J Cardiothorac Vasc Anesth. 2012;26(1):83–9.PubMedCrossRefGoogle Scholar
  96. 96.
    Pintaric TS, Potocnik I, Hadzic A, Stupnik T, Pintaric M, Novak JV. Comparison of continuous thoracic epidural with paravertebral block on perioperative analgesia and hemodynamic stability in patients having open lung surgery. Reg Anesth Pain Med. 2011;36(3):256–60.PubMedCrossRefGoogle Scholar
  97. 97.
    McGlothlin D, Ivascu N, Heerdt PM. Anesthesia and pulmonary hypertension. Prog Cardiovasc Dis. 2012;55(2):199–217.PubMedCrossRefGoogle Scholar
  98. 98.
    Strumpher J, Jacobsohn E. Pulmonary hypertension and right ventricular dysfunction: physiology and perioperative management. YJCAN Elsevier Inc. 2011;25(4):687–704.Google Scholar
  99. 99.
    Şentürk M, Slinger P, Cohen E. Intraoperative mechanical ventilation strategies for one-lung ventilation. Best Pract Res Clin Anaesthesiol Elsevier Ltd. 2015;29(3):357–69.CrossRefGoogle Scholar
  100. 100.
    Brassard CL, Lohser J, Donati F, Bussières JS. Step-by-step clinical management of one-lung ventilation: continuing professional development. Can J Anaesth. 2014;61(12):1103–21.PubMedCrossRefGoogle Scholar
  101. 101.
    Magnusson L, Spahn DR. New concepts of atelectasis during general anaesthesia. Br J Anaesth. 2003;91(1):61–72.PubMedPubMedCentralCrossRefGoogle Scholar
  102. 102.
    Roberts DH, Lepore JJ, Maroo A, Semigran MJ, Ginns LC. Oxygen therapy improves cardiac index and pulmonary vascular resistance in patients with pulmonary hypertension. Chest. 2001;120(5):1547–55.PubMedCrossRefGoogle Scholar
  103. 103.
    Gordon JB, Rehorst-Paea LA, Hoffman GM, Nelin LD. Pulmonary vascular responses during acute and sustained respiratory alkalosis or acidosis in intact newborn piglets. Pediatr Res. 1999;46(6):735–41.PubMedCrossRefGoogle Scholar
  104. 104.
    Moreira GA, O'Donnell DC, Tod ML, Madden JA, Gordon JB. Discordant effects of alkalosis on elevated pulmonary vascular resistance and vascular reactivity in lamb lungs. Crit Care Med. 1999;27(9):1838–42.PubMedCrossRefGoogle Scholar
  105. 105.
    Doras C, Le Guen M, Peták F, Habre W. Cardiorespiratory effects of recruitment maneuvers and positive end expiratory pressure in an experimental context of acute lung injury and pulmonary hypertension. BMC Pulm Med BioMed Central. 2015;15(1):82.CrossRefGoogle Scholar
  106. 106.
    Takeuchi M, Imanaka H, Tachibana K, Ogino H, Ando M, Nishimura M. Recruitment maneuver and high positive end-expiratory pressure improve hypoxemia in patients after pulmonary thromboendarterectomy for chronic pulmonary thromboembolism. Crit Care Med. 2005;33(9):2010–4.PubMedCrossRefGoogle Scholar
  107. 107.
    Hwang W, Jeon J. The effect of iloprost on arterial oxygenation during one-lung ventilation. Eur Respir J. 2016;48(suppl 60):OA1987.Google Scholar
  108. 108.
    Hill LL, Pearl RG. Combined inhaled nitric oxide and inhaled prostacyclin during experimental chronic pulmonary hypertension. J Appl Physiol. 1999;86(4):1160–4.PubMedCrossRefGoogle Scholar
  109. 109.
    Flondor M, Merkel M, Hofstetter C, Irlbeck M, Frey L, Zwissler B. The effect of inhaled nitric oxide and inhaled iloprost on hypoxaemia in a patient with pulmonary hypertension after pulmonary thrombarterectomy. Anaesthesia. 2006;61(12):1200–3.PubMedCrossRefGoogle Scholar
  110. 110.
    Hughes CG, Weavind L, Banerjee A, Mercaldo ND, Schildcrout JS, Pandharipande PP. Intraoperative risk factors for acute respiratory distress syndrome in critically ill patients. Anesth Analg. 2010;111(2):464–7.PubMedCrossRefGoogle Scholar
  111. 111.
    Chau EHL, Slinger P. Perioperative fluid management for pulmonary resection surgery and esophagectomy. Semin Cardiothorac Vasc Anesth. 2014;18(1):36–44.PubMedCrossRefGoogle Scholar
  112. 112.
    Licker M, de Perrot M, Spiliopoulos A, Robert J, Diaper J, Chevalley C, et al. Risk factors for acute lung injury after thoracic surgery for lung cancer. Anesth Analg. 2003;97(6):1558–65.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Vaporciyan AA, Rice D, Correa AM, Walsh G, Putnam JB, Swisher S, et al. Resection of advanced thoracic malignancies requiring cardiopulmonary bypass. Eur J Cardiothorac Surg. 2002;22(1):47–52.PubMedCrossRefGoogle Scholar
  114. 114.
    Slinger P, Kilpatrick B. Perioperative lung protection strategies in cardiothoracic anesthesia. Anesthesiol Clin. 2012;30(4):607–28.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Assaad S, Popescu W, Perrino A. Fluid management in thoracic surgery. Curr Opin Anaesthesiol. 2013;26(1):31–9.PubMedCrossRefGoogle Scholar
  116. 116.
    Kozian A, Schilling T, Röcken C, Breitling C, Hachenberg T, Hedenstierna G. Increased alveolar damage after mechanical ventilation in a porcine model of thoracic surgery. J Cardiothorac Vasc Anesth. 2010;24(4):617–23.PubMedCrossRefGoogle Scholar
  117. 117.
    Arslantas MK, Kara HV, Tuncer BB, Yildizeli B, Yuksel M, Bostanci K, et al. Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections. J Thorac Cardiovasc Surg Elsevier Inc. 2015;149(1):314–20. 321.e1.CrossRefGoogle Scholar
  118. 118.
    Rocca GD, Vetrugno L. Fluid therapy today: where are we? Turk J Anaesth Reanim. 2016;44(5):233–5.CrossRefGoogle Scholar
  119. 119.
    Licker M, Triponez F, Ellenberger C, Karenovics W. Fluid therapy in thoracic surgery: a zero-balance target is always best! Turk J Anaesth Reanim. 2016;44(5):227–9.CrossRefGoogle Scholar
  120. 120.
    Rinieri P, Peillon C, Bessou JP, Veber B, Falcoz PE, Melki J, et al. National review of use of extracorporeal membrane oxygenation as respiratory support in thoracic surgery excluding lung transplantation. Eur J Cardiothorac Surg. 2014;47(1):87–94.PubMedCrossRefGoogle Scholar
  121. 121.
    Rosskopfova P, Perentes JY, Ris H-B, Gronchi F, Krueger T, Gonzalez M. Extracorporeal support for pulmonary resection: current indications and results. World J Surg Oncol. 2016;14:1–10.CrossRefGoogle Scholar
  122. 122.
    Lei J, Su K, Li XF, Zhou YA, Han Y, Huang LJ, et al. ECMO-assisted carinal resection and reconstruction after left pneumonectomy. J Cardiothorac Surg 5th ed. 2010;5(1):89.CrossRefGoogle Scholar
  123. 123.
    Lang G, Ghanim B, Hotzenecker K, Klikovits T, Matilla JR, Aigner C, et al. Extracorporeal membrane oxygenation support for complex tracheo-bronchial procedures. Eur J Cardiothorac Surg. 2015;47(2):250–6.PubMedCrossRefPubMedCentralGoogle Scholar
  124. 124.
    Ross AF, Ueda K. Pulmonary hypertension in thoracic surgical patients. Curr Opin Anaesthesiol. 2010;23(1):25–33.PubMedCrossRefGoogle Scholar
  125. 125.
    Warner DO. Preventing postoperative pulmonary complications. Anesthesiology. 2000;92(5):1467–72.PubMedCrossRefGoogle Scholar
  126. 126.
    Lawrence VA. Strategies to reduce postoperative pulmonary complications after noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006;144(8):596.PubMedCrossRefGoogle Scholar
  127. 127.
    Smetana GW. Postoperative pulmonary complications: an update on risk assessment and reduction. Cleve Clin J Med. 2009;76(Suppl_4):S60–5.PubMedCrossRefGoogle Scholar
  128. 128.
    Marseu K, Slinger P. Peri-operative pulmonary dysfunction and protection. Anaesthesia 1st ed. 2016;Suppl 1(S1):46–50.CrossRefGoogle Scholar
  129. 129.
    Fernando HC, Jaklitsch MT, Walsh GL, Tisdale JE, Bridges CD, Mitchell JD, et al. The Society of Thoracic Surgeons practice guideline on the prophylaxis and management of atrial fibrillation associated with general thoracic surgery: executive summary. Ann Thorac Surg. 2011;92(3):1144–52.PubMedCrossRefGoogle Scholar
  130. 130.
    Olsson KM, Nickel NP, Tongers J, Hoeper MM. Atrial flutter and fibrillation in patients with pulmonary hypertension. Int J Cardiol. 2013;167(5):2300–5.PubMedCrossRefGoogle Scholar
  131. 131.
    Peacock A, Ross K. Pulmonary hypertension: a contraindication to the use of -adrenoceptor blocking agents. Thorax BMJ Publishing Group Ltd. 2010;65(5):454–5.Google Scholar
  132. 132.
    Frendl G, Sodickson AC, Chung MK, Waldo AL, Gersh BJ, Tisdale JE, et al. 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. J Thorac Cardiovasc Surg. 2014;148(3):e153–93.PubMedPubMedCentralCrossRefGoogle Scholar
  133. 133.
    Fischer LG, Aken HV, Bürkle H. Management of pulmonary hypertension: physiological and pharmacological considerations for anesthesiologists. Anesth Analg. 2003;96(6):1603–16.PubMedCrossRefGoogle Scholar
  134. 134.
    Trachte AL, Lobato EB, Urdaneta F, Hess PJ, Klodell CT, Martin TD, et al. Oral sildenafil reduces pulmonary hypertension after cardiac surgery. Ann Thorac Surg. 2005;79(1):194–7.PubMedCrossRefGoogle Scholar
  135. 135.
    Elias S, Sviri S, Orenbuch-Harroch E, Fellig Y, Ben-Yehuda A, Fridlender ZG, et al. The use of sildenafil to facilitate weaning from inhaled nitric oxide (iNO) and mechanical ventilation in a patient with severe secondary pulmonary hypertension and a patent foramen Ovale. Respir Care. 2011;56(10):1611–3.PubMedGoogle Scholar
  136. 136.
    Lee JE, Hillier SC, Knoderer CA. Use of sildenafil to facilitate weaning from inhaled nitric oxide in children with pulmonary hypertension following surgery for congenital heart disease. J Intensive Care Med. 2008;23(5):329–34.PubMedCrossRefGoogle Scholar
  137. 137.
    Namachivayam P, Theilen U, Butt WW, Cooper SM, Penny DJ, Shekerdemian LS. Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children. Am J Respir Crit Care Med. 2006;174(9):1042–7.PubMedCrossRefGoogle Scholar
  138. 138.
    Fischer GW, Cohen E. An update on anesthesia for thoracoscopic surgery. Curr Opin Anaesthesiol. 2010;23(1):7–11.PubMedCrossRefPubMedCentralGoogle Scholar
  139. 139.
    Y. L. Kwak, C. S. Lee, Y. H. Park, Y. W. Hong, (2002) The effect of phenylephrine and norepinephrine in patients with chronic pulmonary hypertension*. Anaesthesia 57(1):9–14.PubMedCrossRefGoogle Scholar
  140. 140.
    Xibing Ding, Shuqing Jin, Xiaoyin Niu, Hao Ren, Shukun Fu, Quan Li, Giovanni Landoni, (2014) A Comparison of the Analgesia Efficacy and Side Effects of Paravertebral Compared with Epidural Blockade for Thoracotomy: An Updated Meta-Analysis. PLoS ONE 9(5):e96233.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Anesthesia and Pain ManagementToronto General Hospital, University Health Network and University of TorontoTorontoCanada

Personalised recommendations