Progressive systemic sclerosis: clinical manifestations and anesthetic considerations.

Progressive systemic sclerosis is a complex disease that involves multiple organ systems. Patients with progressive systemic sclerosis can pose a significant challenge for the anesthesiologist. As the disease progresses, profound musculoskeletal, gastrointestinal, pulmonary, renal, and cardiac system changes occur. The anesthesiologist should understand these complex pathophysiological processes so as to minimize potential risks, including aspiration and other pulmonary complications. In addition, the potential for reduced renal function and intraoperative hypothermia-induced vasospasm must be considered.