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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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ANESTHESIA  SMART 2004 - Milan, May 12-14, 2004

Minerva Anestesiologica 2004 May;70(5):307-12

language: English

Surgical treatment of end stage emphysema

Cohen E.

Thoracic Anesthesia, The Mount Sinai School of Medicine, New York New York, USA


Emphysematous changes are common in the general population. A significant number of these patients requires surgical interventions. Lung volume reduction surgery (LVRS) rapidly gained popularity without a sufficient evidence of beneficial outcome; the presumed mechanism of improvement in lung function is secondary to re-expansion of more normal, underlying compressed lung. The NETT study proposed to evaluate effectiveness of medical treatment vs LVRS in patients with severe bilateral emphysema. Complete results of the NETT study are unknown yet, but there are evidences of beneficial effects of LVRS, at least in a short term. The anesthetic management of these patients includes the continuation of the bronchodilator therapy till surgery, the use of steroids and antisialologue. Pain relief must be optimal and mobilization must be early. One lung ventilation is an absolute necessity, achieved with double lumen tube insertion.

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