BookJayashree Sood, Shikha Sharma, editors.
Summary: This book covers all aspects of thoracic anesthesia to equip the anesthesiologist in dealing with patient care from the time of admission to discharge. Apart from an understanding of anatomy, physiology, pathophysiology, and imaging in thoracic anesthesia this book provides important nuggets of patient examination to help in decision making. Chapters provide information on the interpretation of various tests and intra-operative data for successful conduct of the surgery. This book aims to be an efficient resource for anesthesia practitioners as well as trainees in learning about the full range of challenges faced while performing thoracic anesthesia.
Contents:
Intro
Preface
Acknowledgment
Contents
About the Editors
Part I: Preoperative Considerations
1: History of Thoracic Surgery and Anesthesia
1.1 Negative Pressure, Positive Pressure Ventilation, and Endotracheal Tubes
1.2 The Biggest Obstacle in the Way of Successful Thoracic Surgery
1.3 Bronchoscopy
1.4 The Problem of Cross-Contamination
1.5 Patient Position and Lung Contamination
1.6 Chest Tubes
1.7 Role of Physiologists
1.8 DLT in Clinical Use
1.9 Bronchial Blockers
1.10 Modification and Further Advancements 1.11 Evolution of Lung Isolating Devices
1.12 Arrival of Fiberoptics
References
2: Ethical and Philosophical Considerations in Thoracic Anesthesia
2.1 Introduction
2.2 Philosophical Considerations of Thoracic Anesthesia
2.3 Ethical Considerations
2.3.1 Ethical Principles Governing Medical Ethics
2.3.1.1 The Golden Four Principles of Ethics: [13]
Principle of Respect for Patient Autonomy
Principle of Beneficence
Principle of Non-maleficence
Principle of Justice
2.3.2 The ICMR Twelve Principles of Ethics 2.4 Special Considerations in Thoracic Anesthesia
2.4.1 The Communication Challenge
2.4.2 Managing Conflicts of Interest (COI)
2.4.3 Research in Thoracic Anesthesia
2.4.4 Blood Transfusion Practices in Thoracic Anesthesia
2.5 Conclusions
References
3: Functional Anatomy of Thorax
3.1 Upper Airway
3.2 Pharynx
3.3 Larynx
3.4 Trachea and Bronchial Tree
3.4.1 Relations of Trachea
3.4.2 Bronchus
3.4.3 Innervation
3.4.4 Circulation of the Tracheobronchial Tree
3.5 Pleura and Lungs
3.5.1 Clinical Implication
3.6 Lungs 3.6.1 Lung Border
3.6.2 Innervation of the Lungs
3.6.3 Nutrition to the Lungs
3.7 Conclusion
References
4: Lung Physiology Relevant to Thoracic Anesthesia
4.1 Ventilation
4.2 Compliance
4.3 Resistance of the Respiratory System
4.4 Distribution of Inhaled Air
4.5 Closure of Airways
4.6 Diffusion of Gas
4.7 Distribution of Blood Flow
4.8 Perfusion
4.9 Hypoxic Pulmonary Vasoconstriction (HPV)
4.10 Anesthesia and Lung Function
4.11 Gas Exchange and Ventilation-Perfusion Inequality 4.12 Ventilation-Perfusion During One Lung Ventilation (OLV) and Anesthesia
4.13 Lateral Position V/Q Mismatch
4.13.1 Conscious Awake Patient
4.14 Effect of Ventilation
4.15 pH Manipulation
4.16 Supine Position
4.17 Prone Position
4.18 Conclusion
References
5: Thoracic Anesthesia Equipment
5.1 Introduction
5.2 Double-Lumen Endotracheal Tubes
5.3 Selection of the Proper Size of DLT (Refer Chap. 10 for Further Details)
5.3.1 Margin of Safety (Fig. 5.1)
5.3.1.1 Left-Sided Tube
5.3.1.2 Right-Sided Tube
5.3.2 Specific Tubes