Anesthetic considerations for patients with severe emphysematous lung disease.

The pathophysiology, medical and surgical management of emphysema have been reviewed as a foundation to the physiological goals and principles of anesthetic management of patients with emphysema. An understanding of the cardiovascular and respiratory consequences of emphysema combined with anesthesia, PPV, and thoracic surgery is essential to achieving the challenging physiological goals of providing anesthesia, positive pressure and one-lung ventilation, and postoperative analgesia in a manner consistent with rapid postoperative extubation, hemodynamic stability, adequate gas exchange, and minimal barotrauma for this population of patients.