Chapter
Chapter 2 Respiratory physiology
Gas exchange in the lungs
Ventilation:perfusion ratio
Hypoxic pulmonary vasoconstriction
Non-respiratory functions
Effects of anesthesia on respiratory physiology
Physiology of spontaneous ventilation in the lateral decubitus position
Physiology of two-lung ventilation in the lateral decubitus position
Physiology of one-lung ventilation in lateral decubitus position
Chapter 3 Respiratory pharmacology
Drugs active in the respiratory tract
Drugs used in the treatment of asthma and bronchospasm
Effects of drugs used during anesthesia on the respiratory system
Chapter 4 Respiratory diseases
Airway obstruction disorders
ANESTHETIC CONSIDERATIONS IN ASTHMA
Chronic obstructive pulmonary disease
ANESTHETIC CONSIDERATIONS IN COPD
Interstitial lung disease
Occupational lung disease
Diseases involving the pulmonary circulation
ANESTHETIC IMPLICATIONS OF PULMONARY ARTERIAL HYPERTENSION
Chapter 5 Pre-operative assessment of the thoracic surgical patient
Clinical history and examination
Arterial blood gas analysis
Radiological investigations
Computerized tomography (CT)
CT – lymph nodal assessment
CT – metastatic assessment
Magnetic resonance imaging
Positron emission tomography
British Thoracic Society – Guidelines
Indications for lung isolation
Methods and choice of technique
The double lumen endobronchial tube
Right or left-sided tube?
Complications of DLT insertion
Complications associated with the use of bronchial blockers
Which device to use? (Table 6.8)
Lung separation and the difficult airway
Patients with tracheostomy
Chapter 7 Management of one-lung ventilation
Fundamentals of fractional inspired oxygen (FiO2)
Preparation for OLV in the anesthetic room
Choice of anesthetic technique
Oxygen desaturation (< 90%)
Lung that does not collapse
Positive end-expiratory pressure (PEEP)
Section 2 Anesthesia for operative procedures
Chapter 8 Anesthetic implications of bronchoscopy
Anesthesia for bronchoscopy
Positive pressure ventilation
Emerging from the anesthetic
Rigid bronchoscopy for major events
Rigid bronchoscopy for the emergent technologies
Words about fiberoptics (Box 8.1)
Chapter 9 Anesthesia for tracheal surgery
Pathophysiology of tracheal stenosis
Management and preparation for tracheal resection
Chapter 10 Anesthesia for mediastinoscopy and mediastinal surgery
Assessment of patients for mediastinal surgery
Anesthesia for cervical mediastinoscopy
Complications of mediastinoscopy
Anesthesia for anterior mediastinotomy
Anesthesia for resection of mediastinal masses
Anesthesia for thymectomy in myasthenia
Chapter 11 Anesthesia for video-assisted thoracoscopic surgery
Principles of thoracoscopic surgery
Intra-operative management
Carbon dioxide insufflation
Video-assisted thoracoscopic lung resection
Conversion to thoracotomy
Chapter 12 Anesthesia for lung resection
Limited resections: segmental or wedge resections
Post-operative considerations
Post-operative considerations
Post-operative considerations
Chapter 13 Surgical treatment options for emphysema
Indications and selection criteria
Surgical options for advanced emphysema
Bullectomy (via thoracotomy or VATs)
Lung volume reduction surgery (LVRS) (via median sternotomy or thoracotomy or VATs)
Lung transplantation (LTx) (via thoracotomy, clamshell incisions or median sternotomy)
Anesthetic and operative considerations
Peri-operative monitoring
Choice of anesthetic agent
Complications associated with LVRS
Innovative interventions for advanced emphysema
Chapter 14 Lung transplantation
Lung recipient assessment and selection
Lung donor criteria and selection
Lung recipient-donor matching
Lung retrieval and preservation
Anesthesia for single lung transplantation
Problems with one-lung anesthesia
Pulmonary artery clamping
Anesthesia for sequential bilateral lung transplantation
Peri- and post-operative care for lung transplants
Outcomes and complications of lung transplantation
Chapter 15 Anesthesia for pulmonary endarterectomy
Chronic thromboembolic pulmonary hypertension
Pulmonary endarterectomy (PEA)
MAINTENANCE OF ANESTHESIA
INTENSIVE CARE MANAGEMENT
RESIDUAL PULMONARY HYPERTENSION
Chapter 16 Anesthesia for esophageal surgery
Trans-hiatal esophagectomy
Pre-anesthetic and pre-operative evaluation
Pre-operative considerations
Induction of anesthesia and airway management
Intra-operative considerations: positioning
Anesthetic management for gastro-esophageal reflux surgery
Anesthetic considerations
Chapter 17 Anesthesia for pleural and chest wall surgery
Surgical management of empyema
Chapter 18 Anesthetic implications for management of thoracic trauma
Mechanism of injury after thoracic trauma
Anesthetic implications for management of thoracic trauma
Assessment of patients with thoracic trauma
Fluid management in patients with thoracic trauma
Anesthetic considerations for emergency and urgent thoracotomy
Anesthetic considerations
Airway management in thoracic trauma
Chapter 19 Pediatric thoracic procedures
Factors unique to the pediatric thoracic patient
One-lung ventilation in pediatric practice
Intra-operative management – general principles
Techniques for OLV in pediatric patients
Deliberate endobronchial intubation
Double lumen cuffed endotracheal tubes
The endobronchial blocker
Peri-operative analgesia for pediatric thoracic patients
Intra-operative management – specific conditions
Congenital lobar emphysema (CLE), congenital cystic adenomatous malformation (CCAM), sequestrum
Tracheo-esophageal fistula (TOF) repair
Congenital diaphragmatic hernia (CDH)
Bronchoscopy/bronchography
Chapter 20 Significance of age in practice of thoracic anesthesia
Effect of age on thoracic anesthesia
Age and the risk–benefit equation in thoracic anesthesia and surgery
Pre-anesthetic assessment
Screening for cardiovascular comorbidities
Estimation of cardiac reserve
Screening for pulmonary comorbidities
Response to general anesthesia
Outcomes: specific procedure-related mortality and morbidity
Neurocognitive dysfunction after elderly thoracic surgery
Chapter 21 Management of the morbidly obese patient
Risk reduction strategies in the peri-operative period
Placement of double lumen tubes (DLT) and one-lung ventilation (OLV) in morbidly obese patients
Chapter 22 Management of thoracic surgical emergencies
Tension pneumothorax during one-lung ventilation
Causes of tension pneumothorax during thoracic surgery
Hemorrhage into the airways
Myocardial ischemia and infarction with heart failure
Complications during mediastinoscopy
Superior vena cava obstruction
Section 3 Post-operative management
Chapter 23 Peri-operative intravenous fluid management
Effects of surgical trauma
Physiological changes resulting in fluid retention
Physiological changes to the lungs
Early cardiac response to lung resection
Fluid management in the peri-operative period
Assessment of intravascular filling status in the peri-operative period
Blood transfusion in thoracic surgery
Chapter 24 General post-operative management
Early post-operative management
Management of the chest drains
Chest tubes after pneumonectomy
Post-operative delirium after thoracic surgery
Chapter 25 Management of post-operative respiratory problems
Extubation and airway concerns
Post-operative respiratory failure
Ventilatory support after thoracic surgery
Non-invasive vs. invasive ventilation
Post-pneumonectomy pulmonary edema and acute lung injury
Prevention of ALI/ARDS post-lung resection
Management of ALI/ARDS post-lung resection
General supportive treatment
Chapter 26 Extracorporeal membrane oxygenation (ECMO) and related technologies
Rationale for the use of ECMO
Evidence for the efficacy of ECMO
The assessment of lung recovery during ECMO
Scenarios in which ECMO is useful
Neonatal respiratory failure with meconium aspiration
Adult respiratory distress syndrome (ARDS)
Acute lung failure after pulmonary transplantation
Chapter 27 Management of bronchopleural fistula
Anesthetic considerations
Mechanical ventilation for patients with BPF
Surgical closure of the BPF
Chapter 28 Pain management after thoracotomy
Neural input and locations of pain
Posterolateral thoracotomy
Muscle-sparing thoracotomy
ANATOMICAL CONSIDERATIONS
COMPLICATIONS OF PARAVERTEBRAL ANALGESIA
Intrathecal opioid analgesia
COMPLICATIONS OF INTRATHECAL OPIOIDS
EPIDURAL ANALGESIA VS. INTRAVENOUS MORPHINE BY PCA
EPIDURAL VS. PARAVERTEBRAL ANALGESIA
COMPLICATIONS OF EPIDURALS
Chapter 29 Chronic pain after thoracic surgery
Mechanism of neuropathic pain
Pre-emptive analgesia for prevention of chronic post-thoracotomy pain
Surgical aspects of chronic post-thoracotomy pain
Management of neuropathic pain
Transcutaneous electrical nerve stimulation
Chapter 30 Arrhythmias after thoracic surgery
Causes of arrhythmias after thoracic surgery
Risk factors for arrhythmias
Multifocal atrial tachycardia
Drug treatment of supra-ventricular arrhythmias
Anti-arrhythmic drug prophylaxis
Core Topics in Thoracic Anesthesia
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