52 Y/O MALE 王xx , past history: 僵直性脊椎炎, bronchiectasis waiting for lung transplantation
Pre-op medication: IL-2 Immunosuppressive drug for 1 dose
Induction: DLT with balanced anesthesia
Monitor: swan-ganz, trauma set, a-line, TEE, CPB 備用
Maintance: 限水, FFP, keep renal perfusion, heparin 100 iu/kg,
Surgical procedure: 先換嚴重側, 翻書式開法, 先給solu-medral 500 mg 後換上新肺葉接 A-V-bronchus,
若有需要拔出氣管內管及swan, 後用新肺換氣, TV: 200~300ml,
RR: 14~16 看ABG, 若氧氣好就+solumedrol 500mg 換另外一邊肺, 若不好就ON CPB
TEE: 術前: wall motion, TR, MR, right heart size, RA-RV pressure gradient (CW 看P=4V2 + RA PRESSURE=CVP, 用TRACE 算V的平均值 , 4- CHAMBER VIEW 轉30 DEGREE), pul,hypertension +/-
術後: 有無 right side heart failure sign, fluid status, pressure gradient
Post-op evaluation: peak-inspiratory-pressure的下降,若下降可試著脫離呼吸器,
lung compliance, fulid balance,Pain control: IV PCA or epidural after few days
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住戶編號:2028043
檢舉原因
心情: 
