Anesthetic management during bronchoscopy of patients with pulmonary hypertension

This article is intended to provide an overview of the anesthetic management for bronchoscopic procedures in patients with pulmonary hypertension (PH). This includes the classifications of PH, diagnosis with severity, and treatment modalities as detailed knowledge of this condition is imperative for proper anesthetic management. Preoperative evaluation and optimization of the patient is discussed as well. Bronchoscopic procedures require airway manipulation and compromise ventilation for lengths of time. As hypoxemia and hypercarbia trigger decompensation in PH, this may lead to a downward spiral if control is lost. Therefore a discussion of the intraoperative anesthetic management and the critical concerns are detailed in this article, as well as treatment modalities and management for said concerns.