Pulmonary Injury Causing a Massive Air Leak During Liver Transplantation: A Case Report and Discussion of Decision-Making.

IF 0.5

A&A Practice Pub Date : 2023-06-01 DOI:10.1213/XAA.0000000000001694

Orestes Mavrothalassitis, Sivan Goldenberg Marcus, Garrett R Roll, Roberta Teixeira Tallarico, Michael P Bokoch

引用次数: 0

Abstract

Pulmonary injury can occur during liver transplantation in patients with prior liver surgery, infection, or hepatocellular carcinoma treatments. Compromise of gas exchange during liver transplantation mandates rapid, multidisciplinary decision-making. We present a case of lung parenchymal injury causing a massive air leak during the dissection phase of a liver transplant. An endobronchial blocker was used for emergency lung isolation. Since oxygenation and pH were stable, we proceeded with liver transplantation to minimize graft ischemic time, followed by thoracic repair. The postoperative course was notable for adequate early liver function and discharge after prolonged postoperative ventilation and tube thoracostomy drainage.

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肝移植术中肺损伤引起大量漏气一例报告及决策讨论。

在肝移植过程中，既往有肝手术、感染或肝细胞癌治疗的患者可发生肺损伤。肝移植过程中气体交换的妥协要求快速、多学科的决策。我们提出一个病例肺实质损伤造成大量漏气在解剖阶段的肝移植。支气管内阻滞剂用于紧急肺隔离。由于氧合和pH稳定，我们继续进行肝移植以减少移植物缺血时间，随后进行胸部修复。术后过程中值得注意的是早期肝功能良好，术后长时间通气和插管开胸引流后出院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.