Hensley's Practical Approach to Cardiothoracic Anesthesia

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IV. Thoracic Anesthesia

3. Anesthesia: General anesthesia (volatile or TIVA) with an 8.5 ETT and paralysis. Positive-pressure ventilation is maintained, with a tidal volume of 8-10 mL/kg of ideal body weight, PEEP of 8-10 cm H 2 O, the lowest possible Fio 2 , and intermittent breath holding with the adjustable pressure-limiting (APL) valve at 20-40 cm H 2 O for recruitment. 11 Due to the elevated intrathoracic pressures, continuous invasive or noninvasive blood pressure monitoring may be required.

Copyright © 2024 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. FIGURE 26.3 Navigational bronchoscopy. (A) The patient is under general endotracheal anesthesia with neuromus cular blockade. Patient positioning requires placement of a location board under the thorax (B) and three sensors on the chest (C) . This allows for registration of the patient with a previously acquired computed tomography scan, so that path navigation to the periphery can be calculated (D) . (Images courtesy of Dr Alessia Pedoto.)