Off-Pump Bilateral Cadaveric Lung Transplantation Is Associated With Profound Intraoperative Hypothermia

Dong, Li; Mizota, Toshiyuki; Tanaka, Tomoharu; Chen‐Yoshikawa, Toyofumi F.; Date, Hiroshi; Fukuda, Kazuhiko

doi:10.1053/j.jvca.2016.03.014

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…One study showed that patients undergoing off-pump BLT were at higher risk of profound intraoperative hypothermia despite multimodal preventive therapy. Off-pump SLT had a similar time trend for their body temperature but the extent of the decrease was much smaller than that in off-pump BLT patients 33 …”

Section: Discussionmentioning

confidence: 85%

Bilateral central retinal/ophthalmic artery occlusion and near-complete ophthalmoplegia after bilateral lung transplant

Rady

Kini

et al. 2019

American Journal of Ophthalmology Case Reports

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PurposeRecognize a rare yet existing risk of severe visual loss as a postoperative complication of bilateral lung transplant.ObservationsA 62-year-old male had undergone bilateral lung transplant for end-stage idiopathic pulmonary fibrosis and emphysema overlap syndrome. The operation was initially off-pump; however, during the left lung transplantation, cardiopulmonary bypass conversion was necessary to maintain intraoperative hemodynamic stability. On post-operative day 4, shortly after extubation and full recovery from sedation, the patient reported bilateral no light perception vision. There were no other associated neurologic symptoms. A computed tomographic (CT) of the head, cranial magnetic resonance (MR) scan of the head, MR angiogram of the circle of Willis and neck were negative. Neuro-ophthalmologic examination revealed no light perception vision in both eyes(OU). The pupils were non-reactive to light (amaurotic pupils). The intraocular pressure measured 18 mm Hg OU, and complete bilateral ophthalmoplegia was present. The fundus exam showed bilateral pallid optic disc edema, cherry red spots, with arteriolar attenuation, and mildly dilated and tortuous veins. Stroke work up was negative.Conclusions and importanceA case of post-operative visual loss and ophthalmoplegia carrying significant and permanent quality of life implications. It questions the role disruption of homeostasis during cardiopulmonary bypass contributes for this outcome.

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Section: Discussionmentioning

confidence: 85%

Bilateral central retinal/ophthalmic artery occlusion and near-complete ophthalmoplegia after bilateral lung transplant

Rady

Kini

et al. 2019

American Journal of Ophthalmology Case Reports

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“…Often, surgical technique and cardiac manipulation may lead to major challenges such as hemodynamic instability and cardiovascular collapse. 8 Although this strategy avoids anticoagulation, decreases intraoperative transfusion, and decreases mechanical circulatory support-induced inflammatory response, 9 the off-pump strategy does not allow for controlled graft reperfusion. The overall utilization of the off-pump technique remains controversial and has its own separate considerations and risks, which are beyond the scope of this discussion on perioperative ECLS management.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Circulatory Support and Management for Lung Transplantation: A Case-Based Review

Liang

Fritz

Martin

2022

Semin Cardiothorac Vasc Anesth

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Lung transplantation (LTx) historically was performed with cardiopulmonary bypass (CPB) or Off-pump. Recent data suggest an increased interest in extracorporeal membrane oxygenation (ECMO) as perioperative circulatory support by many lung transplantation centers worldwide. However, there are no established guidelines for anesthetic management for LTx. We present a patient with a history of systemic sclerosis and interstitial lung disease complicated by acute onset of systemic pulmonary hypertension and right heart failure undergoing LTx. We aim to discuss perioperative circulatory support, including ECMO bridge to LTx, and how best to consider the varied intraoperative strategies of CPB vs ECMO vs off-pump during LTx, intraoperative maintenance, and coagulation management.

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Anesthesia for Lung Transplantation in Cystic Fibrosis: Retrospective Review from the Irish National Transplantation Centre

Lenihan

Mullane

Buggy

et al. 2018

Journal of Cardiothoracic and Vascular Anesthesia

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Off-Pump Bilateral Cadaveric Lung Transplantation Is Associated With Profound Intraoperative Hypothermia

Abstract: Patients undergoing off-pump BLT were at high risk of profound intraoperative hypothermia despite multimodal preventive therapy.

Cited by 3 publications

References 20 publications

Bilateral central retinal/ophthalmic artery occlusion and near-complete ophthalmoplegia after bilateral lung transplant

Bilateral central retinal/ophthalmic artery occlusion and near-complete ophthalmoplegia after bilateral lung transplant

Perioperative Circulatory Support and Management for Lung Transplantation: A Case-Based Review

Anesthesia for Lung Transplantation in Cystic Fibrosis: Retrospective Review from the Irish National Transplantation Centre

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