Zusammenfassung
Die Zahl herz- und lungentransplantierter Patienten wächst stetig und ihre Lebenserwartung steigt. Somit nimmt auch die Wahrscheinlichkeit zu, dass einige dieser Patienten Komorbiditäten entwickeln, die einen chirurgischen Eingriff erfordern. Das perioperative anästhesiologische Management herz- und lungentransplantierter Patienten ist eine große Herausforderung – dieser Beitrag gibt einen Überblick.
Abstract
The outcome after heart and lung transplantation has improved significantly. Consequently, many patients are admitted to the hospital for routine surgical interventions that are initially non-transplant-specific. Some disorders lead to hospital admissions that affect other organ systems due to late consequences of the underlying disease or can be seen as early and late complications of the transplantation itself. Many of these surgical interventions are certainly carried out in the responsible transplant centre. Some surgeries are also performed in hospitals that do not primarily transplant and do not regularly care for heart and lung transplant patients. In these situations, the understanding of the physiology of the transplanted heart and lung, the consequences of the underlying disease and the post-transplant treatment with its peculiarities and risks is paramount. The anaesthetic management of these patients requires preoperative risk stratification and perioperative
anaesthetic planning, but also responsibility for a suitable post-operative monitoring. This review article deals with the special anaesthetic consideration in patients after heart and lung transplantation.
Schlüsselwörter
Transplantation - Herztransplantation - Lungentransplantation - anästhesiologisches Management - Beatmung
Key words
heart transplantation - lung transplantation - anaesthetic management - ventilation
